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NPI Code Detail

MEDICARE: DR. ALFREDO M. LOPEZ M.D.

MEDICARE: DR. ALFREDO M. LOPEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician01046966AIN
22084N0400XNeurology Physician01046966AIN
32084N0400XNeurology Physician036-091192IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518958040
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO M. LOPEZ M.D.
Provider Business Mailing Address
First Line : 2060 N SHADELAND AVE
Second Line : STE 200
City : INDIANAPOLIS
State : IN
Zip : 46219-1764
Country : US
Telephone Number : 317-635-3499
Fax Number : 317-635-0449
Provider Business Practice Location Address
First Line : 2060 N SHADELAND AVE
Second Line : STE 200
City : INDIANAPOLIS
State : IN
Zip : 46219-1764
Country : US
Telephone Number : 317-635-3499
Fax Number : 317-635-0449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 04/23/2019

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Directions to “ DR. ALFREDO M. LOPEZ M.D.” Practice Location

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