Individual
GEOFFREY J. GORSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 577-8000
(314) 977-9196
Mailing address
1100 S GRAND BLVD, DRC-8, SAINT LOUIS, MO 63104-1015
(314) 977-5500
(314) 771-3816
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
G37510
CA
207RI0200X
Infectious Disease Physician
Primary
R4J28
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202773909
—
MO
Enumeration date
08/14/2006
Last updated
01/28/2021
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