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Individual

LIV ELIZABETH GORLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10571 TELEGRAPH RD, SUITE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 266-8908
Mailing address
10571 TELEGRAPH RD, SUITE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 266-8908

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101237839
VA
208000000X
Pediatrics Physician
057838
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
561227823A
GA
05
561227823B
GA
Enumeration date
07/05/2006
Last updated
04/11/2024
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