Individual
DR. LUIS GUSTAVO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
618 S MAIN ST, ANESTHESIA DEPT, REIDSVILLE, NC 27320-5020
(336) 951-1010
Mailing address
PO BOX 2627, REIDSVILLE, NC 27323-2627
(336) 951-1010
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
000031135
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8926472
—
NC
Enumeration date
01/26/2006
Last updated
06/04/2008
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