Provider Demographics
NPI:1831180215
Name:GORMAN, RICHARD E (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:GORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:120 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1795
Practice Address - Country:US
Practice Address - Phone:717-217-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053052L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA143050OtherHIGHMARK BLUESHIELD
PA2191573OtherUNITED HEALTH CARE (MAMSI)
PA4549904OtherAETNA NON-HMO
PAP00841788OtherRAILROAD MEDICARE
PA1007307260034OtherMEDICAID GROUP #
PA867633OtherMEDICARE GROUP #
PA6121247OtherAETNA HMO
PA0014851760005Medicaid
PA2191573OtherMAMSI
PA25-1716306OtherDEVON
PAMD053052LOtherLICENSE
PAMD053052LOtherLICENSE
PAP00841788OtherRAILROAD MEDICARE
PA2191573OtherUNITED HEALTH CARE (MAMSI)
PAF85286Medicare UPIN