Provider Demographics
NPI:1972688398
Name:GORMAN, JOHANNA HOPFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:HOPFER
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 1:45 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1915
Mailing Address - Country:US
Mailing Address - Phone:610-933-7749
Mailing Address - Fax:
Practice Address - Street 1:45 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1915
Practice Address - Country:US
Practice Address - Phone:610-933-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035747L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC28348Medicare UPIN
PA038430Medicare ID - Type UnspecifiedPSYCHIATRY