Individual
DR. ROSARIO GONZAGA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
957 NATIONAL HWY, LAVALE, MD 21502-7328
(301) 729-9475
(301) 729-9474
Mailing address
957 NATIONAL HWY, LAVALE, MD 21502-7328
(301) 729-9475
(301) 729-9474
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D22277
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0112098000
MEDICAID
WV
01
—
7124551
CIGNA
—
01
—
840445
MAMSI
—
Enumeration date
05/31/2005
Last updated
07/08/2007
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