Individual
CYNTHIA GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4700 WATES AVE, SAVANNAH, GA 31404
(912) 350-5646
(912) 350-8427
Mailing address
4700 WATES AVE, SAVANNAH, GA 31404
(912) 350-5646
(912) 350-8427
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
054882
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070747455A
—
GA
05
—
070747455B
—
GA
05
—
070747455C
—
GA
05
—
070747455D
—
GA
01
—
10065462
AMERIGROUP
GA
01
—
349774
WELLCARE
GA
05
—
G54882
—
SC
Enumeration date
06/27/2006
Last updated
05/31/2011
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