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Individual
MR. MICHAEL D. GORSLINE
Active
Individual
MR. MICHAEL D. GORSLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
011058-1
NY
363A00000X
Physician Assistant
Primary
MA052217
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02728614
—
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039978
MEDICARE GROUP
PA
01
—
P00304998
RR MEDICARE PIN
PA
Enumeration date
03/22/2006
Last updated
07/29/2011
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