Individual
JEREMIAH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 BEECH ST, CHARLOTTE, MI 48813-1016
(517) 543-2940
(517) 541-0670
Mailing address
804 SERVICE RD STE A202, EAST LANSING, MI 48824-7015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301099387
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
4301099387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306134085
—
MI
Enumeration date
07/15/2011
Last updated
04/28/2026
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