Gonzales, Manuel Borja
Gonzales, Manuel Borja is an individual health care provider with primary practice located at 801 S Adams St Laboratory, Petersburg VA 23803-5149. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Gonzales, Manuel Borja can be contacted via phone (804) 862-5010.Contact Information
Primary practice address
801 S Adams St Laboratory
Petersburg VA 23803-5149
Phone: (804) 862-5010
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 0101026717 | Virginia |
Profile Details
| NPI number | 1447349444 |
|---|---|
| LBN Legal business name | Gonzales, Manuel Borja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Nov 12th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447349444 | NPPES |
| Virginia | MEDICAID | 6680241 | |
| Virginia | Other | 015388 |
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