Individual
DR. MARK LUIS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 MITCHELLVILLE RD STE B128, BOWIE, MD 20716-3144
(301) 809-6305
(301) 809-6306
Mailing address
4000 MITCHELLVILLE RD STE B128, BOWIE, MD 20716-3144
(301) 809-6305
(301) 809-6306
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
PENDING
MD
Other
Enumeration date
05/24/2007
Last updated
10/23/2008
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