Individual
DR. MARIA VIRGINIA GONZAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 10TH AVE, SUITE 300, COLUMBUS, GA 31901-3600
(706) 341-3311
(706) 341-3096
Mailing address
1900 10TH AVE, SUITE 300, COLUMBUS, GA 31901-3600
(706) 341-3311
(706) 341-3096
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
70627
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I164305
MEDICARE PTAN
GA
Enumeration date
05/29/2007
Last updated
12/26/2016
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