Individual
DR. AGNES LOPEZ DALIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
215 NORTH ST STE A, ELKTON, MD 21921-5505
(410) 398-8899
(410) 398-1477
Mailing address
215 NORTH ST STE A, SUITE A PEDIATRICS, ELKTON, MD 21921-5505
(410) 398-8899
(410) 398-1477
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D55214
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
698400200
—
MD
Enumeration date
06/03/2006
Last updated
08/29/2014
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