Individual
TERESA LEE GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2114 GENERALS HWY, ANNAPOLIS, MD 21401-6723
(410) 721-0311
Mailing address
31F QUEEN ANNE WAY, CHESTER, MD 21619-2531
(410) 739-9026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0001196
MD
Other
Enumeration date
06/26/2007
Last updated
11/26/2012
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