Individual
MICHAEL F GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4540
(701) 280-4492
Mailing address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4540
(701) 280-4492
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
9573
ND
208VP0000X
Pain Medicine Physician
Primary
9573
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12928
—
ND
Enumeration date
07/22/2006
Last updated
01/19/2012
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