Individual
CONRADO C GONZALEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6105 HEALTH CENTER LANE, FREDERICKSBURG, VA 22407
(540) 786-5262
(540) 786-5299
Mailing address
PO BOX 31872, RICHMOND, VA 23294-1872
(804) 266-8717
(804) 266-5677
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0101030838
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1243459
CIGNA
—
01
—
142595
ANTHEM BCBS
—
01
—
226152
SOUTHERN HEALTH
—
01
—
3367933
AETNA
—
01
—
396639
MAMSI
—
01
—
5407494
AETNA
—
Enumeration date
02/08/2006
Last updated
04/15/2008
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