Provider Demographics
NPI:1417901893
Name:LOPEZ-CSORBA, MAGALY AURORA (DO)
Entity Type:Individual
Prefix:DR
First Name:MAGALY
Middle Name:AURORA
Last Name:LOPEZ-CSORBA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MAGALY
Other - Middle Name:AURORA
Other - Last Name:LOPEZ-LAREO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:506 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-1310
Mailing Address - Country:US
Mailing Address - Phone:330-875-5625
Mailing Address - Fax:330-875-5723
Practice Address - Street 1:2525 MYERSVILLE RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9752
Practice Address - Country:US
Practice Address - Phone:330-699-3598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000375027OtherANTHEM
OH0142107Medicaid
OH341779226002OtherMED MUTUAL OF OH
OH61641OtherUNITED HEALTHCARE
OH361OtherSUMMACARE
OH341779226002OtherMED MUTUAL OF OH
OHG03411Medicare UPIN