Individual
DR. MICHELL LOPEZ LUCIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-5076
Mailing address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
85050
GA
208M00000X
Hospitalist Physician
85050
GA
Other
Enumeration date
06/28/2017
Last updated
07/21/2022
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