Individual
MICHAEL EDWARD GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4159 MARTHA BERRY HWY NW, ROME, GA 30165-7705
(706) 232-8477
(706) 232-8057
Mailing address
420 E 2ND AVE STE 103, ROME, GA 30161-3210
(706) 509-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
063337
GA
207Q00000X
Family Medicine Physician
MD.43905
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200051359T
—
GA
Enumeration date
03/10/2008
Last updated
02/12/2026
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