Individual
AMANDA E GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4030 WEST HENDERSON ROAD, COLUMBUS, OH 43220
(614) 442-7550
(614) 442-4100
Mailing address
4030 WEST HENDERSON ROAD, COLUMBUS, OH 43220
(614) 442-7550
(614) 442-4100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.089724
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2769857
—
OH
Enumeration date
07/05/2007
Last updated
03/14/2011
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