Gamboa-Gonzalez, Gloria M.

Gamboa-Gonzalez, Gloria M. is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Gamboa-Gonzalez, Gloria M. can be contacted via phone (706) 721-2198.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-2198
Fax: (706) 721-5748
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 048898 Georgia

Profile Details

NPI number 1538279922
LBN Legal business name Gamboa-Gonzalez, Gloria M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Mar 19th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538279922 NPPES
South Carolina MEDICAID G48898
South Carolina MEDICAID 000868436A

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