Individual
MR. LARRY MICHAEL GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
616 SIXTH STREET, BREMERTON, WA 98337
(360) 377-3776
(360) 479-0038
Mailing address
P.O. BOX 960, BREMERTON, WA 98337
(360) 478-2366
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00012059
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1297605
—
WA
Enumeration date
05/01/2007
Last updated
07/08/2007
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