# GREGORY R GORDON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548204464
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD034025E | PA | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 05/20/2021

## 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 |