Ms Celeste D Lopez, MD | |
442 W High St Ste 3, Bryan, OH 43506-1681 | |
(419) 636-4517 | |
(419) 636-6438 |
Full Name | Ms Celeste D Lopez |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 442 W High St Ste 3, Bryan, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962468066 | NPI | - | NPPES |
2173455 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35.077890 (Ohio) | Primary |
Entity Name | Midwest Community Health Associates, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619915170 PECOS PAC ID: 0941114250 Enrollment ID: O20031231000726 |
Mailing Address | Practice Location Address |
---|---|
Ms Celeste D Lopez, MD 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Ms Celeste D Lopez, MD 442 W High St Ste 3, Bryan, OH 43506-1681 Ph: (419) 636-4517 |
Luvenia E. Tantoco, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 442 W High St, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438 | |
Hardev S Sroa, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 442 W High St Ste 3, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438 | |
Kimberly L. Dillon, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 442 W High St Ste 3, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438 |