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Individual

GORDON N SHECKET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 GREENGLADE AVE, WORTHINGTON, OH 43085-2291
(614) 436-6436
Mailing address
501 GREENGLADE AVE, CORPATH-CRED, WORTHINGTON, OH 43085-2291
(614) 436-6436

Taxonomy

Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
35040207
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35040207
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0626960
OH
01
220023091
RR MEDICARE
OH
Enumeration date
08/12/2005
Last updated
08/29/2016
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