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Individual

DR. CARLOS E LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
275 COLLIER RD NW, STE 450, ATLANTA, GA 30309-1709
(404) 355-3161
(404) 355-1353
Mailing address
275 COLLIER RD NW, STE 450, ATLANTA, GA 30309-1709
(404) 355-3161
(404) 355-1353

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
19066
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00211373B
GA
01
0090823
UNITED HEALTHCARE
GA
01
110010115
TRAVELER MEDICARE
GA
01
150542
BLUE CROSS BLUE SHIELD
GA
01
2580839
AETNA
GA
01
581574591
TRICARE
GA
Enumeration date
05/23/2005
Last updated
02/14/2014
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