Provider Demographics
NPI:1396950952
Name:LOPES, THELMA DAHER (MD)
Entity type:Individual
Prefix:
First Name:THELMA
Middle Name:DAHER
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 1:3811 FAIRFAX DR STE 500
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1728
Mailing Address - Country:US
Mailing Address - Phone:202-741-3546
Mailing Address - Fax:202-741-3570
Practice Address - Street 1:MEDICAL FACULTY ASSOCIATES
Practice Address - Street 2:2150 PENNSYLVANIA AVENUE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-3546
Practice Address - Fax:202-741-3570
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD340922085B0100X, 2085N0700X
MO20020100542085N0700X, 2085P0229X
VA01012427502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036389600Medicaid