Mr Antonio Lopez, MD is a medicare enrolled "Internal Medicine" in Detroit, Michigan. His current practice location is
5635 W Fort St, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 849-3920.
Mr Antonio Lopez is licensed to practice in Michigan (license number 4301513129) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083820203.
Provider's Profile
Full Name | Mr Antonio Lopez |
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Gender | Male |
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Speciality | Internal Medicine |
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Location | 5635 W Fort St, Detroit, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1083820203
- Provider Enumeration Date: 05/15/2007
- Last Update Date: 04/01/2025
Medicare PECOS Information:
- PECOS PAC ID: 2163823147
- Enrollment ID: I20210628003399
Medical Identifiers
Medical identifiers for Mr Antonio Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083820203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 4704289261 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (Michigan) | Secondary |
207R00000X | Internal Medicine | 4301513129 (Michigan) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Antonio Lopez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Antonio Lopez, MD 1525 Clark St, Detroit, MI 48209-2136 Ph: () - | Mr Antonio Lopez, MD 5635 W Fort St, Detroit, MI 48209-3154 Ph: (313) 849-3920 |
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