Basic Information
| Provider Information | |||||||||
| NPI: | 1174724397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GONZALEZ-GARCIA | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GONZALEZ | ||||||||
| OtherFirstName: | MICHELLE | ||||||||
| OtherMiddleName: | NICOLE | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4225 ALTAMONT PL | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206953063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018709900 | ||||||||
| FaxNumber: | 8773567301 | ||||||||
| Practice Location | |||||||||
| Address1: | 4225 ALTAMONT PL | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206953063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018709900 | ||||||||
| FaxNumber: | 8773567301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 05/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 45622 | CO | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | D0077024 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.