Individual
DR. DAVID MANUEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 HOSPITAL LN, AFTON, WY 83110-9409
(307) 885-5824
Mailing address
901 ADAMS ST, AFTON, WY 83110-9621
(307) 885-5824
(307) 885-5982
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
26748
CO
207RC0000X
Cardiovascular Disease Physician
Primary
4237A
WY
207RC0000X
Cardiovascular Disease Physician
M-9795
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21403310
—
WY
05
—
807643600
—
ID
Enumeration date
10/11/2005
Last updated
08/25/2022
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