It is important to inform the North Carolina Medical Board of changes in your address and/or your name so that our records may reflect your most current information. Please select the method that bests suits your license type. Please also include your e-mail address(es) and fax number (this information will not be released to the public).

Change of address for licensees
If you are an active physician or physician assistant, you may change your address online by clicking on the green “Start Button” at right to log in to your Licensee Information Page. Select “Address” to update your home or practice address.

Anesthesiologist assistants, clinical pharmacist practitioners, licensed perfusionists and any licensee with an INACTIVE license must submit paper address change forms at this time. Download the form and mail or fax it to the Board’s office. It is not necessary to do both.

Changing your name
Licensees who experience a name change are asked to advise the Board of the change within 30 days. At this time, the Board accepts paper name change forms. Click “Name Change Form” at right to download the form. You may mail or fax the completed form to the Board. 

Professional Corporations and Limited Liability Companies
Corporations and professonal limited liability companies may submit changes of address using the paper form available at right. Please fax or mail the form. Instructions for submitting a corporation/llc name change are provided here.