Individual
MIGUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 MANHATTAN SQ, HAMPTON, VA 23666-5843
(757) 838-8030
Mailing address
7101 HUNTERS CHASE, NORFOLK, VA 23518-4449
(210) 364-9886
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/11/2023
Last updated
01/13/2024
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