Individual
MICHAEL J. GORETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7703
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7703
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
0101225774
VA
2086S0120X
Pediatric Surgery Physician
2014-02561
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006704441
—
VA
05
—
1467466961
—
NC
01
—
216623
ANTHEM BCBS
VA
01
—
26053
OPTIMA/SENTARA HEATLH
VA
01
—
280541
MAMSI/OPTIMUM CHOICE
VA
01
—
311610834
NC HEALTH CHOICE
VA
01
—
3116108340003E
CIGNA
VA
01
—
7712078
AETNA
VA
01
—
89063AN
NORTH CAROLINA MEDICAID
VA
05
—
89063AN
—
NC
05
—
NC2352
—
SC
Enumeration date
07/28/2006
Last updated
12/18/2023
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