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Individual

MR. DAVID J GORECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 LINCOLNWAY, SUITE 310, LA PORTE, IN 46350-3430
(219) 362-7506
(219) 362-1459
Mailing address
PO BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01038951
IN
207RC0000X
Cardiovascular Disease Physician
036 070820
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000514107
ANTHEM, BCBS
IN
05
10016541A
IN
Enumeration date
12/20/2005
Last updated
09/14/2020
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