Provider Demographics
NPI:1639556145
Name:LOPEZ, CARLOS ALBERTO (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 PEACHTREE ST NE APT 716
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1562
Mailing Address - Country:US
Mailing Address - Phone:412-216-3962
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-3816
Practice Address - Country:US
Practice Address - Phone:888-946-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92726207RH0003X
GA90726207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology