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Individual
MARK C. GORRIE
Active
Individual
MARK C. GORRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
02003492A
IN
2085R0202X
Diagnostic Radiology Physician
36113813
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
OS18237
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000618591
ANTHEM BCBS
IN
05
—
112658900
—
FL
05
—
200946010
—
IN
01
—
P00787056
RAILROAD MEDICARE
IN
Enumeration date
08/17/2006
Last updated
09/27/2022
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