STEPHEN G GONSALVES FNP, PHD
NPI 1205316759
Nurse Practitioner - Family in Washington, DC
Active since August 15, 2018
About Stephen G Gonsalves Fnp, Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEPHEN G GONSALVES FNP, PHD (NPI 1205316759) is an individual family provider in Washington, District Of Columbia, licensed in Maryland (R136201) and active in the NPI registry since August 2018. He maintains a secondary practice location in Bethesda.
NPPES Registry Identity
NPI1205316759
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameSTEPHEN G GONSALVESCredential: FNP, PHD
Location Address500 12TH ST SWWashington, DC 20536-5098
Mailing Address217 Creek Valley LnRockville, MD 20850 · (240) 780-6799
Phone(240) 853-5887
Sole ProprietorYes
Enumeration DateAugust 15, 2018
✔ NPI 1205316759 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MD · R136201
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License R136201 (MD)
500 12TH ST SW, Washington, DC 20536
Secondary Practice Location 1
Location 110 Center DriveBethesda, MD 20814 · Phone (240) 780-6799
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205316759, enumerated as an "individual" on August 15, 2018.
The provider is located at 500 12TH ST SW WASHINGTON, DC 20536 and the phone number is (240) 853-5887.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
