Change of Address

Online Address Change

Online Form

Name Change Form

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Professional Corp/PLLC Update

Online Form

Licensees of the North Carolina Medical Board are expected to keep a current address and/or name on file with the Board. Physicians and PAs must change their address online using the process described below. Please be sure to check and update your our email address(es) and fax number (this information will not be released to the public).

Change of address for ACTIVE physicians and physician assistants
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.

Change of address for other license types
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
Active professional corporations and professional limited liability companies may change their addresses online via the Professional Corp/PLLC Information Update portal. Access the Information Update portal by clicking on the green button at right.

Professional Corporation/PLLC Name Change
Instructions for requesting a professional corporation or PLLC name change are available in the Guide for Professional Corporations and PLLCs.