Healthcare Provider Details

I. General information

NPI: 1861440216
Provider Name (Legal Business Name): ALVARO J LOPEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 MONTREAL RD #130
TUCKER GA
30084-8128
US

IV. Provider business mailing address

1700 HOSPITAL SOUTH DR STE 402
AUSTELL GA
30106-8116
US

V. Phone/Fax

Practice location:
  • Phone: 770-939-1601
  • Fax:
Mailing address:
  • Phone: 770-739-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number034184
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number34184
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: