Provider Demographics
NPI:1275514465
Name:LOPATINE, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:LOPATINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9084
Mailing Address - Country:US
Mailing Address - Phone:770-474-1919
Mailing Address - Fax:770-474-7832
Practice Address - Street 1:350 COUNTRY CLUB DR
Practice Address - Street 2:SUITE D
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9084
Practice Address - Country:US
Practice Address - Phone:770-474-1919
Practice Address - Fax:770-474-7832
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046612207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1024702OtherCIGNA ID
GA52494178OtherBLUE CROSS BLUE SHIELD ID
GA1221679OtherUNITED HEALTHCARE
GA492356OtherAETNA PROVIDER ID
GA00821741AMedicaid
GA1024702OtherCIGNA ID
GA16BDSWSMedicare ID - Type UnspecifiedMEDICARE PROVIDER ID