Healthcare Provider Details

I. General information

NPI: 1871567800
Provider Name (Legal Business Name): ROBERTO CARLOS LOPEZ-SOLIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
MORGANTOWN WV
26506-1200
US

IV. Provider business mailing address

1 MEDICAL CENTER DR
MORGANTOWN WV
26506-1200
US

V. Phone/Fax

Practice location:
  • Phone: 855-988-2273
  • Fax:
Mailing address:
  • Phone: 855-988-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD426331
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: