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NPI Code Detail

MEDICARE: DR. LISA BRYCE LOPEZ MD

MEDICARE: DR. LISA BRYCE LOPEZ MD
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
1208000000XPediatrics Physician24855SC

General Provider Information

NPI Number : 1821109323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA BRYCE LOPEZ MD
Provider Business Mailing Address
First Line : PO BOX 751461
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1461
Country : US
Telephone Number : 843-792-1414
Fax Number :
Provider Business Practice Location Address
First Line : 2713 DANTZLER DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9005
Country : US
Telephone Number : 843-764-1722
Fax Number : 843-764-1788
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/16/2026

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Directions to “ DR. LISA BRYCE LOPEZ MD” Practice Location

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