Individual
DR. ERNESTO GONZALEZ-MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 STANIFORD ST, SUITE 200, BOSTON, MA 02114-2517
(617) 726-2914
(617) 726-7768
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2914
(617) 726-7768
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40589
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040589
TUFTS HEALTH PLAN
MA
05
—
2053586
—
MA
01
—
M09515
BCBS MA
MA
Enumeration date
11/16/2005
Last updated
08/01/2012
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