Provider Demographics
NPI:1225012214
Name:LOPRESTI, BARTHOLOMEW MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:BARTHOLOMEW
Middle Name:MICHAEL
Last Name:LOPRESTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20209 SENTARA WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:CARROLLTON
Mailing Address - State:VA
Mailing Address - Zip Code:23314-3573
Mailing Address - Country:US
Mailing Address - Phone:757-542-2000
Mailing Address - Fax:757-542-2001
Practice Address - Street 1:20209 SENTARA WAY
Practice Address - Street 2:STE 200
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-3573
Practice Address - Country:US
Practice Address - Phone:757-542-2000
Practice Address - Fax:757-542-2001
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5624304Medicaid
VA381158OtherANTHEM PROVIDER NUMBER
VA61014OtherOPTIMA HEALTH PROVDER NO.
VAC60275Medicare UPIN
VA080002142Medicare ID - Type Unspecified