Provider Demographics
NPI:1790779932
Name:GONZALEZ, STEVEN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:GONZALEZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2832 DUANE PLZ
Mailing Address - Street 2:APARTMENT G
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-5598
Mailing Address - Country:US
Mailing Address - Phone:402-331-2435
Mailing Address - Fax:
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:VA NEBRASKA-WESTERN IOWA HEALTH CARE SYSTEM
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-346-8800
Practice Address - Fax:402-943-5550
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NENE21115207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine