# MR. DOMINGO GONZALES JAVIER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699872135
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 10588 | WV | Yes |

## Other

- **Enumeration date:** 09/19/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0127512000 | — | WV |
| 01 | — | 0472131 | UMWA FUNDS | — |
| 01 | — | 062480 | BC ANTHEM | VA |
| 01 | — | 1022384 | WORKERS COMP | WV |
| 01 | — | 103541 | BLACK LUNG | — |
| 01 | — | 4454937 | AETNA | — |
| 01 | — | 7350431 | VA MED ASSIS | VA |
| 01 | — | 851945 | MAMSI | — |
| 01 | — | V000267 | CHAMPUS | — |