Individual
LOUIS ALFRED LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
604 W BERRY ST, FORT WAYNE, IN 46802-2106
(260) 423-1331
(260) 422-1046
Mailing address
604 W BERRY ST, FORT WAYNE, IN 46802-2106
(260) 423-1331
(260) 422-1046
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01045695A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108750A
—
IN
Enumeration date
08/29/2006
Last updated
09/29/2020
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