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1356459218 NPI number — STEVEN G LOPEZ MD

NPI Number: 1356459218
Health Care Provider/Practitioner: STEVEN G LOPEZ MD

Information about “1356459218” NPI (STEVEN G LOPEZ MD) exists in 1356459218 in HTML format HTML  |  1356459218 in plain Text format TXT  |  1356459218 in PDF (Portable Document Format) PDF  |  1356459218 in an XML format XML  formats.

NPI Number : 1356459218 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356459218",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LOPEZ",
    "FirstName": "STEVEN",
    "MiddleName": "G",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2777 SPEISSEGGER DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHARLESTON",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29405-8229",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "843-747-5830",
    "MailingAddressFaxNumber": "843-745-5115",
    "FirstLinePracticeLocationAddress": "4500 LEEDS AVE",
    "SecondLinePracticeLocationAddress": "STE. 219",
    "PracticeLocationAddressCityName": "N CHARLESTON",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29405-8520",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "843-745-5178",
    "PracticeLocationAddressFaxNumber": "843-745-5115",
    "EnumerationDate": "08/29/2006",
    "LastUpdateDate": "02/10/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2084P0800X",
        "TaxonomyName": "Psychiatry Physician",
        "LicenseNumber": "20247",
        "LicenseNumberStateCode": "SC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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