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General NPI Number Information
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NPI Number | 1952389876
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Entity Type | Individual
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Provider Name | HECTOR M LOPEZ MD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 4931 S 27TH ST SUITE 200
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City | GREENFIELD
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State | WI
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Zip | 53221-2652
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Country | US
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Telephone | 414-546-3400
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Fax | 414-546-3500
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Provider Business Mailing Address
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Address Line | 4931 S 27TH ST SUITE 200
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City | GREENFIELD
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State | WI
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Zip | 53221-2652
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Country | US
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Telephone | 414-546-3400
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Fax | 414-546-3500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33647
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License Number State | WI
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