Lopez, Mark Daniel

Lopez, Mark Daniel is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Lopez, Mark Daniel can be contacted via phone (706) 721-4951.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-4951
Fax: (706) 721-7941
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 049055 Georgia

Profile Details

NPI number 1053420257
LBN Legal business name Lopez, Mark Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Nov 30th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053420257 NPPES
South Carolina MEDICAID G49055
South Carolina MEDICAID 000875388A

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