Individual
GREGORY S GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 738-5510
(219) 738-6714
Mailing address
20021 MOHAWK TRL, OLYMPIA FIELDS, IL 60461-1125
(708) 481-6894
(708) 481-4018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01038358
IN
207R00000X
Internal Medicine Physician
01038358
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100365270
—
IN
Enumeration date
09/12/2005
Last updated
08/01/2019
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