Individual
STEVEN G GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19920
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081310
—
OR
01
—
MD19920
MD LICENSE #
OR
Enumeration date
11/18/2005
Last updated
07/09/2007
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