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Individual

RICHARD W GORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1401 GEORGIAN PARK, SUITE 200, PEACHTREE CITY, GA 30269-6974
(770) 632-8909
Mailing address
433 QUARTERS RD, FAYETTEVILLE, GA 30215-5634
(770) 487-3326

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GA031008
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00380212C
GA
Enumeration date
05/15/2006
Last updated
03/22/2010
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