Individual
PAUL C GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 COLLYER ST, STE 100, PROVIDENCE, RI 02904
(401) 793-7191
(401) 793-7200
Mailing address
117 ELLENFIELD ST, SUITE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD8392
RI
207RI0011X
Interventional Cardiology Physician
Primary
MD8392
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9006737
—
RI
Enumeration date
07/11/2006
Last updated
03/27/2015
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