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Individual

GREGORY R GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
333 N OXFORD VALLEY RD, STE 201, FAIRLESS HILLS, PA 19030
(215) 946-1500
(215) 946-3417
Mailing address
41 UNIVERSITY DR, SUITE 300, NEWTOWN, PA 18940-1873
(215) 710-5522
(215) 710-5181

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD034025E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010906390006
PA
01
0022624000
KEYSTONE IBC
PA
01
053505
HIGHMARK BLUE SHIELD
PA
01
30165547
KEYSTONE FIRST
PA
01
4217615
AETNA
PA
01
7241941
CIGNA PA
PA
01
P01193810
RAILROAD MEDICARE
PA
Enumeration date
06/15/2006
Last updated
05/20/2021
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