Individual
PURITA B. GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1145 19TH STREET, NW, SUITE 850, WASHINGTON, DC 20036
(202) 223-9040
(202) 223-9047
Mailing address
1145 19TH STREET, NW, SUITE 850, WASHINGTON, DC 20036
(202) 223-9040
(202) 223-9047
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD25753
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201701700
—
DC
01
—
5552-0006
CAREFIRST BCBS
DC
Enumeration date
10/04/2006
Last updated
11/09/2010
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