Organization
MARYLAND INSTITUTE FOR PELVIC NEURO SCIENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A GORDON MD (PRESIDENT)
(410) 343-3001
Entity
Organization
Contact information
Practice address
1447 YORK ROAD, SUITE 406, LUTHERVILLE, MD 21093-6017
(410) 343-3001
(410) 823-0015
Mailing address
1447 YORK ROAD, SUITE 406, LUTHERVILLE, MD 21093
(410) 343-3002
(410) 823-0015
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Enumeration date
05/24/2016
Last updated
09/25/2023
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