MEDICARE: DR. WILLIAM LOPEZ DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00337500	NJ

General Provider Information

NPI Number	:	1538573910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LOPEZ DPM

Provider Business Mailing Address
First Line	:	22 CLAY ST
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4255
Country	:	US
Telephone Number	:	908-337-9689
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 CLAY ST
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4255
Country	:	US
Telephone Number	:	908-337-9689
Fax Number	:

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

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	07/21/2022

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