Individual
THEA GAY LOPEZ MANLAPAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5601 LOCH RAVEN BLVD, RUSSELL MORGAN BLDG 3RD FLOOR, BALTIMORE, MD 21239-2945
(443) 444-5600
(410) 435-5367
Mailing address
5601 LOCH RAVEN BLVD, RUSSELL MORGAN BLDG 3RD FLOOR, BALTIMORE, MD 21239-2945
(443) 444-5600
(410) 435-5367
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0075104
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/16/2010
Last updated
09/28/2016
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