Provider Demographics
NPI:1679615975
Name:GORMAN, BARRY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:CHARLES
Last Name:GORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1483 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5703
Mailing Address - Country:US
Mailing Address - Phone:703-356-8774
Mailing Address - Fax:703-356-8719
Practice Address - Street 1:1483 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5703
Practice Address - Country:US
Practice Address - Phone:703-356-8774
Practice Address - Fax:703-356-8719
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA272552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry