Healthcare Provider Details

I. General information

NPI: 1396950952
Provider Name (Legal Business Name): THELMA DAHER LOPES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 11/15/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL FACULTY ASSOCIATES 2150 PENNSYLVANIA AVENUE
WASHINGTON DC
20037
US

IV. Provider business mailing address

3811 FAIRFAX DR STE 500
ARLINGTON VA
22203-1728
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3546
  • Fax: 202-741-3570
Mailing address:
  • Phone: 202-741-3546
  • Fax: 202-741-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD34092
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number2002010054
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number2002010054
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101242750
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberMD34092
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: