Provider Demographics
NPI:1578312815
Name:GORMAN, ANN MARGARET
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARGARET
Last Name:GORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 LOVING WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-3612
Mailing Address - Country:US
Mailing Address - Phone:443-975-2537
Mailing Address - Fax:
Practice Address - Street 1:12000 TRADITIONS BLVD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3658
Practice Address - Country:US
Practice Address - Phone:240-329-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program