Individual
DR. ANDREW JOHN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Contact information
Practice address
601 JOHN ST STE M-283, KALAMAZOO, MI 49007-5382
(269) 349-7696
Mailing address
601 JOHN ST STE M-283, KALAMAZOO, MI 49007-5382
(269) 349-7696
(269) 349-0610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
AG067751
MI
208600000X
Surgery Physician
Primary
4301067751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A312720
BCBSM GROUP ID
MI
05
—
4227783
—
MI
05
—
4848964
—
MI
Enumeration date
06/21/2006
Last updated
01/13/2020
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