Provider Demographics
NPI:1831151760
Name:GORMLEY, WILLIAM B (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:GORMLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:60 FENWOOD RD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6128
Mailing Address - Country:US
Mailing Address - Phone:617-732-8554
Mailing Address - Fax:
Practice Address - Street 1:60 FENWOOD RD DEPT OF
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6128
Practice Address - Country:US
Practice Address - Phone:617-732-8554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0785207RC0200X
MA226751207T00000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery