Individual
DR. MATTHEW GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4140 CENTENNIAL HILLS BLVD, STE A, CASPER, WY 82609
(307) 265-7205
(307) 235-6262
Mailing address
4140 CENTENNIAL HILLS BLVD, STE A, CASPER, WY 82609-3265
(307) 265-7205
(307) 235-6262
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7771A
WY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
7771A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315221
BCBS
WY
01
—
P00412109
RAILROAD MEDICARE PTAN
WY
Enumeration date
03/14/2007
Last updated
08/15/2018
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