Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 35.091344 | OH |
N | 2086S0129X | Vascular Surgeon | MD60398838 | WA |
Y | 2086S0129X | Vascular Surgeon | ME115599 | FL |
NPI | 1114041126 |
---|---|
Provider Name | Dr. Alberto Jose Lopez |
First Address | Beavercreek, OH 45440-4419 |
Second Address | Beavercreek, OH 45440-4419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 20/08/2013 |