Individual
TERCIO LOPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1378 NW 124TH ST, CLIVE, IA 50325-8151
(515) 288-6097
Mailing address
1378 NW 124TH ST, CLIVE, IA 50325-8151
(515) 288-6097
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
104509
MN
207RG0100X
Gastroenterology Physician
27245
AL
207RG0100X
Gastroenterology Physician
Primary
38798
IA
207RG0100X
Gastroenterology Physician
52288
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
05/08/2007
Last updated
05/06/2015
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