Individual
CHAD MICHAEL GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4403 HARRISON BLVD, SUITE 2855, OGDEN, UT 84403-3323
(801) 387-2550
(801) 387-2564
Mailing address
4403 HARRISON BLVD, SUITE 2855, OGDEN, UT 84403-3323
(801) 387-2550
(801) 387-2564
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4825699-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00237064
RAILROAD MEDICARE
UT
Enumeration date
02/21/2006
Last updated
02/19/2019
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