Provider Demographics
NPI:1255303897
Name:LOPEZ, SHERI DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:DENISE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7955
Mailing Address - Country:US
Mailing Address - Phone:706-243-4500
Mailing Address - Fax:706-243-4503
Practice Address - Street 1:2121 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7955
Practice Address - Country:US
Practice Address - Phone:706-243-4500
Practice Address - Fax:706-243-4503
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2244207RC0000X
VA0101229121207R00000X
IL036-115315207RC0000X
GA69023207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129758AMedicaid