Individual
DR. DANIEL CANDELARIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5440 HILLANDALE DR, KAISER PERMANENTE PANOLA MEDICAL CENTER, LITHONIA, GA 30058-4865
(770) 322-2777
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
064597
GA
207Q00000X
Family Medicine Physician
140922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769875211A
—
GA
Enumeration date
07/10/2007
Last updated
01/10/2022
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