Individual
GORDON ENNS
Active
Individual
GORDON ENNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD10734
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023507000
BLUE CROSS BLUE SHIELD
OR
05
—
235101
—
OR
01
—
930079056
RAILROAD MEDICARE
—
01
—
97520A009
CHAMPUS
—
01
—
C91177
GROUP HEALTH
—
01
—
XPY185046
MEDI - CAL
—
Enumeration date
04/03/2006
Last updated
07/14/2014
Update your record
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