MEDICARE: DR. ANN ELIZABETH GORMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	16961	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659305670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN ELIZABETH GORMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 22829
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29925-2829
Country	:	US
Telephone Number	:	843-681-4977
Fax Number	:	843-681-9126

Provider Business Practice Location Address
First Line	:	100 EXCHANGE ST STE 200
Second Line	:
City	:	HILTON HEAD ISLAND
State	:	SC
Zip	:	29926-7901
Country	:	US
Telephone Number	:	843-681-4977
Fax Number	:	843-681-7233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/14/2011

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