Individual
MICHAEL WREN GORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1538 13TH. AVE., SUITE B300, COLUMBUS, GA 31901-3700
(706) 321-9300
(706) 321-9384
Mailing address
1538 13TH AVE, STE B300, COLUMBUS, GA 31901-2563
(706) 321-9300
(706) 321-9384
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
44471
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000766004B
—
GA
01
—
367345
BCBS PROVIDER NUMBER
GA
Enumeration date
12/15/2006
Last updated
09/17/2019
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