Individual
CECILIA BERNADETTE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
212 S SALEM ST, APEX, NC 27502-1825
(919) 362-5201
Mailing address
2620 NEW BERN AVE, RALEIGH, NC 27610-1821
(919) 833-3111
(919) 832-3112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200301233
NC
207Q00000X
Family Medicine Physician
OS9461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89135MO
—
NC
01
—
OS9461
MEDICAL LICENSE
FL
Enumeration date
12/08/2006
Last updated
09/28/2011
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