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Individual

DR. LUIS ANTONIO GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1015 SPRING ST, SUITE 206, SILVER SPRING, MD 20910-4012
(301) 588-9595
(301) 588-9525
Mailing address
13425 SILVER MOON WAY, SILVER SPRING, MD 20904-1257
(301) 879-8782

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0056791
MD
207R00000X
Internal Medicine Physician
MD034535
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2389415
UNITED HEALTHCARE
MD
01
3430563
AETNA HMO
MD
01
51807
AMERIGROUP
MD
01
783ALA
CARE FIRST BCBS
MD
01
7980239
AETNA PPO
MD
01
8128088
MAMSI OPTIMUM CHOICE
MD
01
J730
CARE FIRST BCBS
DC
Enumeration date
09/22/2006
Last updated
10/12/2007
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