Provider Demographics
NPI:1659305670
Name:GORMAN, ANN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELIZABETH
Last Name:GORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22829
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29925-2829
Mailing Address - Country:US
Mailing Address - Phone:843-681-4977
Mailing Address - Fax:843-681-9126
Practice Address - Street 1:100 EXCHANGE ST STE 200
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-7901
Practice Address - Country:US
Practice Address - Phone:843-681-4977
Practice Address - Fax:843-681-7233
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16961207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC169613Medicaid
SC169613Medicaid