Individual
CARLA R GOERISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1230 E MAIN STREET, MANKATO CLINIC AT MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
1230 E MAIN ST PO BOX 8674, MANKATO CLINIC LTD, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
43507
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701675
MEDICA
MN
01
—
151849
UCARE
MN
01
—
160054398
RR MEDICARE
—
01
—
1694574
AMERICAS PPO
MN
01
—
410849339 56001 C183
CHAMPUS
—
01
—
45D45GO
BCBS
MN
05
—
729415800
—
MN
01
—
HP33855
HEALTH PARTNERS
MN
01
—
NA2951027673
PREFERRED ONE
MN
Enumeration date
01/09/2006
Last updated
07/10/2020
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