Individual
DR. KEVIN GERARD LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4710 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-2155
(505) 955-9454
(505) 888-9644
Mailing address
PO BOX 6880, SANTA FE, NM 87502-6880
(505) 216-0332
(505) 982-0279
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
36573
AZ
207Q00000X
Family Medicine Physician
Primary
MD2020-0934
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51507307
—
NM
Enumeration date
02/09/2007
Last updated
08/31/2023
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