Individual
NI GORSUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 N ELAM AVE, GREENSBORO, NC 27403-1118
(336) 832-1100
Mailing address
415 MORRIS STREET, SUITE 304, CHARLESTON, WV 25301
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
201401288
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036972000
—
MN
01
—
P00413286
RAILROAD MEDICARE
MN
Enumeration date
08/01/2006
Last updated
09/17/2021
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