Individual
DR. JOSEPH P LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 CEDAR ST SE STE 820, ALBUQUERQUE, NM 87106-4912
(505) 841-1434
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
81-254
NM
208600000X
Surgery Physician
Primary
81-254
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020041679
PALMETTORAILROADMEDICARE
NM
05
—
08383
—
NM
01
—
NM011699
BLUECROSSBLUESHIELD
NM
Enumeration date
04/06/2006
Last updated
03/15/2021
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