Provider Demographics
NPI:1336117589
Name:LOPEZ, GLADYS HELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:HELENA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GLADYS
Other - Middle Name:HELENA
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:900 CATON AVE
Mailing Address - Street 2:ST. AGNES HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5201
Mailing Address - Country:US
Mailing Address - Phone:410-368-6000
Mailing Address - Fax:
Practice Address - Street 1:900 CATON AVE
Practice Address - Street 2:ST. AGNES HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061799207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405296000Medicaid
MD114508Medicare UPIN
MD017599E14Medicare ID - Type Unspecified
I14508Medicare UPIN