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General NPI Number Information
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NPI Number | 1043485196
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Entity Type | Organization
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Legal Business Name | NORTHERN MOBILE MEDICAL DIAGNOSTICS
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 1084 INDUSTRIAL PKWY SUITE B
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City | SARALAND
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State | AL
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Zip | 36571-3726
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Country | US
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Telephone | 251-675-8760
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Fax | 251-675-8100
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Provider Business Mailing Address
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Address Line | 1084 INDUSTRIAL PARKWAY SUITE B
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City | SARALAND
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State | AL
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Zip | 36571
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Country | US
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Telephone | 251-675-8760
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Fax | 251-675-8100
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. OSCAR B LOPEZ
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Credential | M.D.
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Telephone | 251-675-8760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 10060
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License Number State | AL
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