Individual
DR. JUAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 LACEY ST, DEPT PATHOLOGY, CAPE GIRARDEAU, MO 63701-5230
(314) 362-5641
(314) 362-0369
Mailing address
660 S EUCLID AVE, CB 8118, SAINT LOUIS, MO 63110-1010
(314) 362-5641
(314) 362-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
R2F61
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202688800
—
MO
Enumeration date
07/03/2006
Last updated
11/15/2021
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