Individual
CHARLES DAVID GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6324 FAIRVIEW RD STE 400, CHARLOTTE, NC 28210-4278
(980) 302-8626
(980) 302-8639
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9437
(704) 384-9440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45189
AZ
2084N0400X
Neurology Physician
Primary
2012-01542
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921444
—
NC
05
—
630053
—
AZ
Enumeration date
10/02/2006
Last updated
06/11/2021
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