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NPI Code Detail

MEDICARE: MR. ADAM LOPEZ M.A./CCC-A

MEDICARE:  MR. ADAM  LOPEZ  M.A./CCC-A
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
1231H00000XAudiologistAUD003745GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619933801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADAM LOPEZ M.A./CCC-A
Provider Business Mailing Address
First Line : 2176 OAK RD STE D
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-2374
Country : US
Telephone Number : 770-972-4327
Fax Number : 770-972-4101
Provider Business Practice Location Address
First Line : 2176 OAK RD STE D
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-2374
Country : US
Telephone Number : 770-972-4327
Fax Number : 770-972-4101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 08/02/2024

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Directions to “ MR. ADAM LOPEZ M.A./CCC-A” Practice Location

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