Individual
DR. GARY CHARLES JORDAN
Active
Individual
DR. GARY CHARLES JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
213123
MA
207R00000X
Internal Medicine Physician
MD08294
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007009305
—
RI
01
—
04-05379
UNITED HEALTHCARE
RI
05
—
110078711A
—
MA
01
—
2643-9
BLUE CROSS
RI
01
—
2690610
AETNA
RI
01
—
27633
NEIGHBORHOOD HEALTH PLAN
RI
01
—
401734
BLUE CHIP
RI
01
—
404565
TUFTS HEALTH PLAN
RI
01
—
5631596001
CIGNA
RI
01
—
AA33702
HARVARD HEALTH PLAN
RI
01
—
MD08294
BLUE CHOICE
RI
Enumeration date
12/12/2006
Last updated
07/26/2013
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