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NPI Code Detail

MEDICARE: DR. MICHAEL LOUIS GORJANC MD

MEDICARE: DR. MICHAEL LOUIS GORJANC MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician51883-20WI
22084P0800XPsychiatry Physician35.091146OH

General Provider Information

NPI Number : 1124228523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL LOUIS GORJANC MD
Provider Business Mailing Address
First Line : 9220 MENTOR AVE
Second Line : BEACON HEALTH
City : MENTOR
State : OH
Zip : 44060-6412
Country : US
Telephone Number : 440-639-3509
Fax Number : 440-205-1009
Provider Business Practice Location Address
First Line : 9220 MENTOR AVE
Second Line : BEACON HEALTH
City : MENTOR
State : OH
Zip : 44060-6412
Country : US
Telephone Number : 440-639-3509
Fax Number : 440-205-1009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2007
Last Update Date : 09/30/2015

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