Individual
MARLIS GONZALEZ-FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 532-4701
Mailing address
PO BOX 64407, BALTIMORE, MD 21264-4407
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D61807
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407206500
—
MD
Enumeration date
05/17/2006
Last updated
01/24/2013
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