Individual
KERRY L GORSUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1787 GRAND RIDGE CT NE, GRAND RAPIDS, MI 49525-7042
(616) 913-8601
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 913-1818
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301054541
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2997348
—
MI
05
—
3021247
—
MI
05
—
4117781
—
MI
05
—
4878257
—
MI
05
—
4878408
—
MI
05
—
4878785
—
MI
Enumeration date
07/06/2006
Last updated
07/08/2007
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