Individual
JOHN EDWARD LOPES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4273 CORPORATE DR, MT PLEASANT, MI 48858
(989) 953-4357
Mailing address
4273 CORPORATE DR, MT PLEASANT, MI 48858-5321
(989) 953-4357
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601004789
STATE LICENSE
MI
Enumeration date
01/04/2007
Last updated
06/20/2018
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