Individual
DR. ALEX LOGAN GORNITZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301507007
MI
207XP3100X
Pediatric Orthopaedic Surgery Physician
MT222132
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT222132
PA MEDICAL LICENSE
PA
Enumeration date
03/25/2016
Last updated
08/19/2022
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