Individual
GARY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE, SUITE 137 LANKENAU MEDICAL BLDG., WYNNEWOOD, PA 19096-3450
(610) 896-8400
(610) 896-9652
Mailing address
100 LANCASTER AVENUE, SUITE 137, WYNNEWOOD, PA 19096
(610) 896-8400
(610) 896-9652
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD017706E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11966
—
PA
Enumeration date
06/27/2006
Last updated
11/02/2012
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