Individual
JUAN MIRANDA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 GEIPE RD STE 230, CATONSVILLE, MD 21228
(410) 247-7500
(410) 247-4227
Mailing address
PO BOX 846173, DALLAS, TX 75284-6173
(410) 247-7500
(410) 247-4227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D62197
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406269800
—
MD
Enumeration date
12/13/2005
Last updated
07/31/2018
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