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General NPI Number Information
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NPI Number | 1275723413
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Entity Type | Organization
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Legal Business Name | GEORGE A. GONZALEZ, M.D., P.C.
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 131 OLD ROAD TO 9 ACRE COR SUITE 660
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City | CONCORD
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State | MA
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Zip | 01742-4181
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Country | US
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Telephone | 978-287-2934
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Fax | 978-287-2934
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Provider Business Mailing Address
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Address Line | 131 OLD ROAD TO 9 ACRE COR SUITE 660
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City | CONCORD
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State | MA
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Zip | 01742-4181
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Country | US
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Telephone | 978-287-2934
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Fax | 978-287-2934
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE ANDREW GONZALEZ
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Credential | M.D.
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Telephone | 305-773-9386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 231414
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 231414
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License Number State | MA
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