Gough, Richard L

Gough, Richard L is an individual health care provider with primary practice located at 19 W Frederick St , Walkersville MD 21793-8230. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gough, Richard L can be contacted via phone (301) 845-6336.

Contact Information

Primary practice address
19 W Frederick St Walkersville MD 21793-8230
Phone: (301) 845-6336
Fax: (240) 578-4478
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0032171 Maryland
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X D0032171 Maryland

Profile Details

NPI number 1346223955
LBN Legal business name Gough, Richard L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2005
Last updated Aug 2nd, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346223955 NPPES
Maryland MEDICAID 926580505
Maryland MEDICAID 926580506

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