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Individual
ROBERT T GORDON
Active
Individual
ROBERT T GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
5310
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060031670
RAILROAD MEDICARE
SD
01
—
4995658
BLUE CROSS OF SD
SD
05
—
7301930
—
SD
Enumeration date
06/07/2006
Last updated
12/27/2021
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