Individual
GLORIA M. GAMBOA-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2198
(706) 721-5748
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8403
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
048898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000868436A
—
GA
05
—
G48898
—
SC
Enumeration date
08/30/2006
Last updated
03/19/2014
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