Healthcare Provider Details

I. General information

NPI: 1811570179
Provider Name (Legal Business Name): ADRIAN MARCELO GONZALEZ GIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date: 04/26/2022
Reactivation Date: 05/23/2022

III. Provider practice location address

1015 DUFF AVE
AMES IA
50010-5733
US

IV. Provider business mailing address

1215 DUFF AVE
AMES IA
50010-5469
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4440
  • Fax:
Mailing address:
  • Phone: 515-239-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD-55811
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: