Individual
STEPHEN G GONSALVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP, PHD
Contact information
Practice address
500 12TH ST SW, WASHINGTON, DC 20536-5098
(240) 853-5887
Mailing address
217 CREEK VALLEY LN, ROCKVILLE, MD 20850
(240) 780-6799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R136201
MD
363LP2300X
Primary Care Nurse Practitioner
R136201
MD
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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