Individual
MR. EUGENIO DE JESUS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-7000
Mailing address
1135 MILITARY CUTOFF RD STE 103, WILMINGTON, NC 28405-3685
(910) 256-6222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103739
NC
363AM0700X
Medical Physician Assistant
NC103739
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0932PA
—
SC
05
—
1972522779
—
NC
Enumeration date
07/19/2006
Last updated
06/26/2025
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