Provider Demographics
NPI:1548354699
Name:LOPEZ-STRATTON, ANNA ELISA (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELISA
Last Name:LOPEZ-STRATTON
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:PO BOX 603250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3250
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:360 HOSPITAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-0107
Practice Address - Country:US
Practice Address - Phone:828-456-9006
Practice Address - Fax:828-456-8199
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60444089207Q00000X
NC9700405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1548354699Medicaid
NCNCM344F135OtherMEDICARE PTAN
WA1548354699Medicaid
WAG8927317, G8927318Medicare PIN