Provider Demographics
NPI:1396059085
Name:LOPES, JOANNE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:MARIE
Last Name:LOPES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 GREENWICH RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6047
Mailing Address - Country:US
Mailing Address - Phone:757-497-5400
Mailing Address - Fax:757-497-8811
Practice Address - Street 1:5121 GREENWICH RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6047
Practice Address - Country:US
Practice Address - Phone:757-497-5400
Practice Address - Fax:757-497-8811
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist