Provider Demographics
NPI:1790071371
Name:GONZALEZ, JOAN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2595
Mailing Address - Country:US
Mailing Address - Phone:571-786-1492
Mailing Address - Fax:703-642-7565
Practice Address - Street 1:4208 EVERGREEN LN
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3235
Practice Address - Country:US
Practice Address - Phone:703-642-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313116207Q00000X
PAMT200470207Q00000X
CT52717207Q00000X
VA0101271933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine