Individual
RICHARD STEVEN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10957 NORTHGREEN DR, WELLINGTON, FL 33449-8054
(561) 642-4878
(561) 642-4878
Mailing address
10957 NORTHGREEN DR, WELLINGTON, FL 33449-8054
(561) 642-4878
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
96910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026343
ANTHEM
OH
01
—
027978400
FED BLK LNG
OH
05
—
0752592
—
OH
01
—
127593300
US DEPARTMENT OF LABOR
—
01
—
300016814
RAILROAD MEDICARE
—
01
—
341212779007
MEDICAL MUTUAL
OH
01
—
341212779020
MEDICAL MUTUAL OF OH
OH
Enumeration date
05/17/2006
Last updated
01/05/2016
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