Individual
DR. GORDON GUANXIONG MAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 W. 16TH STREET, GOODMAN HALL SUITE 5100, INDIANAPOLIS, IN 46202
(317) 963-1300
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01085850A
IN
207T00000X
Neurological Surgery Physician
01085850B
IN
207T00000X
Neurological Surgery Physician
MT2050
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT2050
LICENES
—
Enumeration date
07/23/2013
Last updated
02/17/2022
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