Individual
DR. LUIS CARLOS GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
181 INTERSTATE PKWY, BRADFORD, PA 16701-1041
(814) 362-4345
(814) 362-1178
Mailing address
181 INTERSTATE PKWY, BRADFORD, PA 16701-1041
(814) 362-4345
(814) 362-1178
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD054904L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015887450005
—
PA
Enumeration date
07/14/2006
Last updated
02/18/2013
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