Provider Demographics
NPI:1871520346
Name:LOPEZ, ROBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:815 VISTA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4629
Mailing Address - Country:US
Mailing Address - Phone:505-521-2203
Mailing Address - Fax:505-526-7112
Practice Address - Street 1:815 VISTA HILLS DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4629
Practice Address - Country:US
Practice Address - Phone:505-521-2203
Practice Address - Fax:505-526-7112
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMNM82243207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26211Medicaid
NMC34566Medicare UPIN