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Individual

BRIAN GORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBCH

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
36152
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020322000
MN
01
300028385
RAILROAD MEDICARE
MN
05
35139600
WI
05
ENROLLED
IA
05
ENROLLED
SD
Enumeration date
01/20/2006
Last updated
12/05/2012
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