Provider Demographics
NPI:1285637231
Name:LOPEZ, CARLOS E (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:275 COLLIER RD NW
Mailing Address - Street 2:STE 450
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1709
Mailing Address - Country:US
Mailing Address - Phone:404-355-3161
Mailing Address - Fax:404-355-1353
Practice Address - Street 1:275 COLLIER RD NW
Practice Address - Street 2:STE 450
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1709
Practice Address - Country:US
Practice Address - Phone:404-355-3161
Practice Address - Fax:404-355-1353
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA19066207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2580839OtherAETNA
GA0090823OtherUNITED HEALTHCARE
GA110010115OtherTRAVELER MEDICARE
GA150542OtherBLUE CROSS BLUE SHIELD
GA581574591OtherTRICARE
GA581574591OtherCOVENTRY
GA581574591OtherCIGNA
GA581574591OtherPHCS
GA00211373BMedicaid
GA00211373BMedicaid