Individual
MELVIN R GONZAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
957 NATIONAL HWY, STE 3, ATTN: MELVIN GONZAGA, LAVALE, MD 21501-0929
(240) 362-7128
(240) 362-7129
Mailing address
957 NATIONAL HWY, STE 3, ATTN: MELVIN GONZAGA, LAVALE, MD 21501-0929
(240) 362-7128
(240) 362-7129
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D22148
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
961521100
—
MD
Enumeration date
07/15/2006
Last updated
10/02/2013
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