Individual
DR. DAVID LAKE GORMSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1074
(330) 489-1487
Mailing address
4189 SONGBIRD TRL, STOW, OH 44224-2572
(330) 688-4160
(330) 489-1487
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
34002838
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34002838
MEDICAL LICENSE NUMBER
OH
Enumeration date
01/31/2007
Last updated
07/08/2007
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