Provider Demographics
NPI:1821096363
Name:GONZALEZ, RENE MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:MIGUEL
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032860E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
50048291OtherKEYSTONE HEALTH PLAN CENTRAL
9911829OtherCIGNA HEALTHCARE
0013113000OtherAMERIHEALTH
033430OtherHIGHMARK BLUE SHIELD
50048291OtherCAPITAL BLUE CROSS
56208OtherGEISINGER HEALTH PLAN
0013113000OtherINDEPENDENCE BLUE CROSS
2170519OtherMAMSI
P3394608OtherOXFORD HEALTH PLANS
9352078OtherPRIVATE HEALTHCARE SYSTEMS
0013113000OtherKEYSTONE HEALTH PLAN EAST
P00234897OtherMEDICARE RAILROAD
033430OtherHIGHMARK BLUE SHIELD
56208OtherGEISINGER HEALTH PLAN