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Individual
DR. MARK RICHARD GORMAN
Active
Individual
DR. MARK RICHARD GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065330
BCBSAZ PROVIDER #
AZ
01
—
700444
AHCCCS
AZ
Enumeration date
06/22/2005
Last updated
08/08/2022
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