MEDICARE: DR. EMIGDIO ALFAFARA LOPEZ JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0103-031554	VA

General Provider Information

NPI Number	:	1225142821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMIGDIO ALFAFARA LOPEZ JR. M.D.

Provider Business Mailing Address
First Line	:	8346 TRAFORD LN
Second Line	:	SUITE 103-104
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-1600
Country	:	US
Telephone Number	:	703-451-3245
Fax Number	:	703-451-6188

Provider Business Practice Location Address
First Line	:	8346 TRAFORD LN
Second Line	:	SUITE 103-104
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-1600
Country	:	US
Telephone Number	:	703-451-3245
Fax Number	:	703-451-6188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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