Individual
ROBERTO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 946-1655
(814) 949-7616
Mailing address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 946-1655
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD428424
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016685350002
—
PA
01
—
1556942
GATEWAY HEALTH PLAN
PA
01
—
368970
HIGHMARK BC BS
PA
Enumeration date
07/26/2006
Last updated
04/19/2012
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