Individual
DR. ALFREDO M. LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2060 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46219-1764
(317) 635-3499
(317) 635-0449
Mailing address
2060 N SHADELAND AVE, STE 200, INDIANAPOLIS, IN 46219-1764
(317) 635-3499
(317) 635-0449
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01046966A
IN
2084N0400X
Neurology Physician
036-091192
IL
208D00000X
General Practice Physician
Primary
01046966A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200240820
—
IN
Enumeration date
11/03/2005
Last updated
04/23/2019
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