Individual
HUMBERTO CESAR GONZALEZ GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(139) 167-1783
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301089991
MI
207RG0100X
Gastroenterology Physician
107128
MN
207RG0100X
Gastroenterology Physician
Primary
4301089991
MI
207RG0100X
Gastroenterology Physician
51261
TN
207RG0100X
Gastroenterology Physician
56890
MN
207RT0003X
Transplant Hepatology Physician
51261
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04122575
—
MS
05
—
206119001
—
AR
01
—
6025474
BCBS
TN
05
—
Q008639
—
TN
Enumeration date
08/06/2007
Last updated
09/29/2023
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