Most Relevant Information
Provider Data
| NPI Number: | 1003073685 |
| Provider Name: | JED DAVID GONZALO M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 228391 |
Most Important Dates
| Enumeration Date: | 05/21/2008 |
| Last Updated: | 12/28/2022 |
Provider Practice Location
3 RIVERSIDE CIR
ROANOKE
VA
240164955
Practice Location Phone/Fax
| Phone: | 5402245170 |
| Fax: |
Provider Mailing Location
213 S JEFFERSON ST STE 1006
ROANOKE
VA
240111713
Provider Mailing Phone/Fax
| Phone: | 5402245352 |
| Fax: |
Suggested EMR
Internist EMR