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Individual
THERESE FERMO GONZALEZ
Active
Individual
THERESE FERMO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301095835
MI
207R00000X
Internal Medicine Physician
8816
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007610
—
SD
01
—
P1282353
RR MEDICARE
SD
Enumeration date
08/06/2010
Last updated
07/20/2016
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