Individual
MARK E GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 229-3819
(651) 265-7443
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 229-3819
(651) 265-7443
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
36551
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
726263900
—
MN
Enumeration date
07/05/2006
Last updated
03/31/2015
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