Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D69143 | MD |
NPI | 1063636041 |
---|---|
Provider Name | Dr. Mary Elizabeth Gorman |
First Address | Rockville, MD 20852-4908 |
Second Address | Largo, MD 20774-5374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 01/06/2021 |