Individual
DR. DIANE L GORGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8305
(614) 293-3124
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8305
(614) 293-3124
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35062961
OH
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
35062961
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0993519
—
OH
01
—
311229292
GROUP FEDERAL TAX ID#
OH
Enumeration date
10/16/2006
Last updated
04/10/2024
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