Individual
MANUEL F GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
115 N SUMTER ST, SUITE 305, SUMTER, SC 29150-4972
(803) 934-8348
(803) 934-8349
Mailing address
115 N SUMTER ST, SUITE 305, SUMTER, SC 29150-4972
(803) 934-8348
(803) 934-8349
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9747
SC
207RH0003X
Hematology & Oncology Physician
9747
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3381
—
SC
05
—
GP4045
—
SC
Enumeration date
11/25/2005
Last updated
05/27/2014
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