MEDICARE: EDWARD P GORRIE 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
1	207R00000X	Internal Medicine Physician	MD015650E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871525246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD P GORRIE MD

Provider Business Mailing Address
First Line	:	1320N TULIP DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1432
Country	:	US
Telephone Number	:	610-306-0330
Fax Number	:	610-660-1409

Provider Business Practice Location Address
First Line	:	261 CITY AVE
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1835
Country	:	US
Telephone Number	:	610-660-1461
Fax Number	:	610-660-1409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	10/22/2015

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Directions to “ EDWARD P GORRIE MD” Practice Location

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