Organization
GENERAL SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW J GORDON MD (PRESIDENT)
(269) 781-4267
Entity
Organization
Contact information
Practice address
215 E MANSION ST, SUITE 3E, MARSHALL, MI 49068-1559
(269) 781-4267
(269) 781-2710
Mailing address
215 E MANSION ST, SUITE 3E, MARSHALL, MI 49068-1559
(269) 781-4267
(269) 781-2710
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301067751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A310990
BCBSM
MI
01
—
020A312720
BCBSM GROUP ID
MI
01
—
383530765005
TRICARE
MI
01
—
CH0788
RAILROAD MEDICARE
MI
01
—
G5056F
BCN
MI
Enumeration date
06/30/2006
Last updated
10/21/2011
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