| Ronald L Gonzales Md Pllc | |
|
1124 N Saginaw St Saint Charles MI 48655-1021 | |
| (989) 865-8270 | |
| (989) 865-8582 |
| Full Name | Ronald L Gonzales Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1124 N Saginaw St, Saint Charles, Michigan |
| Authorized Official Name and Position | Ronald Gonzales (OWNER) |
| Authorized Official Contact | 9898658270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald L Gonzales Md Pllc 1124 N Saginaw St Saint Charles MI 48655-1021 Ph: (989) 865-8270 | Ronald L Gonzales Md Pllc 1124 N Saginaw St Saint Charles MI 48655-1021 Ph: (989) 865-8270 |
| NPI Number | 1154368439 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 03/30/2021 |
| Medicare PECOS PAC ID | 8325038805 |
|---|---|
| Medicare Enrollment ID | O20040517000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154368439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald L Gonzales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841274909 PECOS PAC ID: 3678563160 Enrollment ID: I20040518000462 |
| Provider Name | Julie A Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871847657 PECOS PAC ID: 5698927630 Enrollment ID: I20121220000248 |
| Provider Name | Heidi R Rethman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861839649 PECOS PAC ID: 6800028994 Enrollment ID: I20140403000885 |
St. Charles Family Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 W Belle Avenue, Saint Charles, MI 48655 Phone: 989-865-9958 Fax: 989-865-8099 |