Individual
MICHAEL JB GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 KINGSTOWN RD, SUITE 200, NARRAGANSETT, RI 02882-3239
(401) 783-6940
(401) 792-3676
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11643
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050513293
UHP
—
Enumeration date
08/03/2005
Last updated
04/02/2024
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