Provider Demographics
NPI:1427116318
Name:LOPEZ, GERMAN (MD)
Entity type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GERMAN
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PMB 647
Mailing Address - Street 2:AVE LUIS VIGOREAUX 1353
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-2715
Mailing Address - Country:US
Mailing Address - Phone:787-754-1422
Mailing Address - Fax:787-754-8555
Practice Address - Street 1:156 ROOSEVELT AVE.
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918-2406
Practice Address - Country:US
Practice Address - Phone:787-754-1422
Practice Address - Fax:787-754-8555
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR113032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology