Provider Demographics
NPI:1124228523
Name:GORJANC, MICHAEL LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:GORJANC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9220 MENTOR AVE
Mailing Address - Street 2:BEACON HEALTH
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6412
Mailing Address - Country:US
Mailing Address - Phone:440-639-3509
Mailing Address - Fax:440-205-1009
Practice Address - Street 1:9220 MENTOR AVE
Practice Address - Street 2:BEACON HEALTH
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6412
Practice Address - Country:US
Practice Address - Phone:440-639-3509
Practice Address - Fax:440-205-1009
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI51883-202084P0800X
OH35.0911462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry