Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 35.059889 | OH |
NPI | 1043292923 |
---|---|
Provider Name | Dr. Michael W Gorsky |
First Address | Beavercreek, OH 45440-3237 |
Second Address | Beavercreek, OH 45440-3237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0785164 | (05) | OH |
E18915 | (02) | OH |