Individual
DR. WANDA LEA GORSUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888
(406) 731-8318
Mailing address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888
(406) 731-8318
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
6360
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000097000
BLUE CROSS BLUE SHIELD
MT
05
—
0080132
—
MT
01
—
0139917
WASHINGTON L & I
MT
01
—
184609700
FEDERAL WORK COMP
MT
01
—
200023483
RAILROAD MEDICARE
MT
01
—
810347861
CHAMPUS
—
01
—
810347861004
EBMS
MT
Enumeration date
06/10/2006
Last updated
04/02/2021
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