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Individual
GREGORY R GORDON
Active
Individual
GREGORY R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD034025E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010906390006
—
PA
01
—
0022624000
KEYSTONE IBC
PA
01
—
053505
HIGHMARK BLUE SHIELD
PA
01
—
30165547
KEYSTONE FIRST
PA
01
—
4217615
AETNA
PA
01
—
7241941
CIGNA PA
PA
01
—
P01193810
RAILROAD MEDICARE
PA
Enumeration date
06/15/2006
Last updated
05/20/2021
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