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General NPI Number Information
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NPI Number | 1922025741
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Entity Type | Organization
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Legal Business Name | ROBERT M. GORSEN M.D.,PHD.,P.C.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 3301 WOODBURN RD SUITE 211
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-573-4700
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Fax | 703-573-7922
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Provider Business Mailing Address
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Address Line | 3301 WOODBURN RD SUITE 211
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City | ANNANDALE
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State | VA
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Zip | 22003-1229
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Country | US
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Telephone | 703-573-4700
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Fax | 703-573-7922
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT M GORSEN
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Credential | MD
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Telephone | 703-573-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 0101042525
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License Number State | VA
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