Individual
JOEL A GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24876
IA
207RN0300X
Nephrology Physician
Primary
24876
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0228817
—
IA
Enumeration date
10/13/2005
Last updated
12/04/2007
Update your record
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