Provider Demographics
NPI:1023244126
Name:GONZALEZ RANGEL, ISMAEL ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:ISMAEL
Middle Name:ENRIQUE
Last Name:GONZALEZ RANGEL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:43200 DEQUINDRE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1707
Mailing Address - Country:US
Mailing Address - Phone:248-780-9490
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:43200 DEQUINDRE RD STE 105
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1707
Practice Address - Country:US
Practice Address - Phone:248-780-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43011007882080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology