Provider Demographics
NPI:1396852786
Name:LOPEZ, ARMANDO E (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:E
Last Name:LOPEZ
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 1:718 SMYTH RD FL 3
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-7007
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:
Practice Address - Street 1:718 SMYTH RD FL 3
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420010357208800000X
NH11485208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00058666OtherBLUE SHIELD
VT402427OtherMVP
VT1008680Medicaid
VT340020261OtherMEDICARE RAILROAD
VT340020261OtherMEDICARE RAILROAD
VT1008680Medicaid