| G Michael Lopez | |
|
105 Mills Ave Ste 300 Las Vegas NM 87701-4169 | |
| (505) 425-9311 | |
| (505) 425-9047 |
| Full Name | G Michael Lopez |
|---|---|
| Speciality | Internal Medicine |
| Location | 105 Mills Ave Ste 300, Las Vegas, New Mexico |
| Authorized Official Name and Position | G Michael Lopez (OWNER) |
| Authorized Official Contact | 5054259311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| G Michael Lopez 105 Mills Ave # 300 Las Vegas NM 87701 Ph: (505) 425-9311 | G Michael Lopez 105 Mills Ave Ste 300 Las Vegas NM 87701-4169 Ph: (505) 425-9311 |
| NPI Number | 1891925848 |
|---|---|
| Provider Enumeration Date | 07/23/2009 |
| Last Update Date | 07/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891925848 | NPI | - | NPPES |
| NM001568 | Other | BLUE CROSS BLUE SHIELD | |
| 201006000 | Other | NM | PRESBYTERIAN HEALTH PLAN |
| 00007070 | Medicaid | NM | |
| NM001568 | Other | NM | BLUE CROSS BLUE SHIELD |
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