Michael J. Goretsky
Pediatric Surgery
1025 Morehead Medical Dr Suite 275
Charlotte
, North Carolina 28204-2963
Michael J. Goretsky
Pediatric Surgery
1025 Morehead Medical Dr Suite 275
Charlotte
, North Carolina 28204-2963
(704) 403-2670
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Michael J. Goretsky
- 1025 Morehead Medical Dr Suite 275
- Charlotte, NC
- Zip : 28204-2963
- Fax : (704) 403-2670
- Phone : (704) 403-2662
Second Address
- Michael J. Goretsky
- 1025 Morehead Medical Dr Suite 275
- Charlotte, NC
- Zip : 28204-2963
- Fax : (704) 403-2670
- Phone : (704) 403-2662
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 2086S0120X | Pediatric Surgery | 0101225774 | VA |
| Y | 2086S0120X | Pediatric Surgery | 2014-02561 | NC |
National Provider Identifier
| NPI | 1467466961 |
|---|---|
| Provider Name | Michael J. Goretsky |
| First Address | Charlotte, NC 28204-2963 |
| Second Address | Charlotte, NC 28204-2963 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2006 |
| Last Update Date | 16/11/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006704441 | (05) | VA |
| 1467466961 | (05) | NC |
| 216623 | ANTHEM BCBS (01) | VA |
| 26053 | OPTIMA/SENTARA HEATLH (01) | VA |
| 280541 | ALLIANCE/MDIPA (01) | VA |
| 280541 | MAMSI/OPTIMUM CHOICE (01) | VA |
| 311610834 | NC HEALTH CHOICE (01) | VA |
| 3116108340003E | CIGNA (01) | VA |
| 7712078 | AETNA (01) | VA |
| 89063AN | (05) | NC |
| 89063AN | NORTH CAROLINA MEDICAID (01) | VA |
| H29917 | (02) | VA |
| NC2352 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.