Provider Demographics
NPI:1598082810
Name:PEREZ, GONZALO ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:GONZALO
Middle Name:ENRIQUE
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 E UNIVERSITY PKWY
Mailing Address - Street 2:DEPTARTMENT OF MEDICINE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2829
Mailing Address - Country:US
Mailing Address - Phone:410-554-2284
Mailing Address - Fax:410-554-2184
Practice Address - Street 1:201 E UNIVERSITY PKWY
Practice Address - Street 2:DEPTARTMENT OF MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2829
Practice Address - Country:US
Practice Address - Phone:410-554-2284
Practice Address - Fax:410-554-2184
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD041756207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program