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Individual

STEVEN ADAM GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
8577 SUDLEY RD STE A, MANASSAS, VA 20110-3860
(703) 368-7166
(703) 368-5103
Mailing address
8577A SUDLEY RD, MANASSAS, VA 20110
(703) 368-7166
(703) 368-5103

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000879
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103000879
UNITED HEALTHCARE
01
027806
ANTHEM BCBS
01
0442570002
DMERC
01
175235R15
MEDICARE TRAILBLAZERS
VA
01
324100
UNITED HEALTHCARE MAMSI
01
480000469
MEDICARE TRAILBLAZERS
VA
01
480000470
MEDICARE TRAILBLAZERS
VA
01
480018959
RAILROAD MEDICARE
05
9301488
VA
01
A8890005
CAREFIRST BCBS
01
CC5940
RAILROAD MEDICARE GROUP
VA
Enumeration date
03/14/2006
Last updated
11/02/2009
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