Healthcare Provider Details

I. General information

NPI: 1881742443
Provider Name (Legal Business Name): MARIA DEL CARMEN LOPEZ-ARVIZU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N BROADWAY
BALTIMORE MD
21205-1832
US

IV. Provider business mailing address

2931 E BIDDLE ST PATIENT ACCOUNTING
BALTIMORE MD
21213-3939
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-9200
  • Fax: 443-923-9405
Mailing address:
  • Phone: 443-923-1886
  • Fax: 443-923-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0061720
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: