Individual
CAMILLE ARIEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6425 W MEQUON RD, MEQUON, WI 53092-1862
(262) 242-0051
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1427622117
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100171819
—
WI
Enumeration date
05/17/2021
Last updated
09/13/2024
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