Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 9900232 | NC |
N | 207RX0202X | Medical Oncology | 9900232 | NC |
NPI | 1033165246 |
---|---|
Provider Name | Richard Forbes Gorman JR. |
First Address | New Bern, NC 28561-2248 |
Second Address | New Bern, NC 28560-3449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 20/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133V2 | BCBS OF NC (01) | NC |
89133V2 | (05) | NC |
H82170 | (02) | NC |