Dr Amante Agustin Lopez, MD | |
327 Medical Park Dr, Bridgeport, WV 26330-9006 | |
(681) 342-1610 | |
(681) 342-1626 |
Full Name | Dr Amante Agustin Lopez |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 327 Medical Park Dr, Bridgeport, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457379935 | NPI | - | NPPES |
001720948 | Other | WV | MOUNTAIN STATE BCBS |
229645 | Other | CARELINK | |
WV16170 | Other | HEALTH PLAN | |
0059024000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 16170 (West Virginia) | Primary |
Entity Name | United Hospital Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760965586 PECOS PAC ID: 8123936010 Enrollment ID: O20031212000802 |
Mailing Address | Practice Location Address |
---|---|
Dr Amante Agustin Lopez, MD 327 Medical Park Dr, Bridgeport, WV 26330-9006 Ph: (681) 342-1000 | Dr Amante Agustin Lopez, MD 327 Medical Park Dr, Bridgeport, WV 26330-9006 Ph: (681) 342-1610 |
Crystal A. De Wit, DO Anesthesiology Medicare: Medicare Enrolled Practice Location: 527 Medical Park Dr Ste 500, Bridgeport, WV 26330 Phone: 681-342-3600 | |
Annas Sabbagh, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 227 Medical Park Dr Ste 103, Bridgeport, WV 26330 Phone: 681-342-3500 | |
Joseph M Folio, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 327 Medical Park Dr, Bridgeport, WV 26330 Phone: 681-342-1000 | |
Frank P Dombkoski, DO Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 327 Medical Park Dr, Anesthesia Dept, Bridgeport, WV 26330 Phone: 681-342-1610 Fax: 681-342-1626 | |
Dr. Scott M Ross, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 327 Medical Park Dr, Bridgeport, WV 26330 Phone: 304-233-2455 | |
Dr. Koshy Mathews Mathai, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 227 Medical Park Dr Ste 103, Bridgeport, WV 26330 Phone: 681-342-3500 |