Gonzalez, Alfonso

Gonzalez, Alfonso is an individual health care provider with primary practice located at 3600 Forest Dr Ste 400 , Columbia SC 29204-4057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as his primary health care specialty. Gonzalez, Alfonso can be contacted via phone (803) 779-7316.

Contact Information

Primary practice address
3600 Forest Dr Ste 400 Columbia SC 29204-4057
Fax: (803) 343-2538
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 17121 South Carolina

Profile Details

NPI number 1912971367
LBN Legal business name Gonzalez, Alfonso
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated May 29th, 2019 - about 5 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 1912971367 NPPES
South Carolina Other 070017292 RAILROAD MEDICARE
South Carolina MEDICAID 171217 RAILROAD MEDICARE

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