Individual
SHOSHANA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
26300 WOODWARD AVE, ROYAL OAK, MI 48067-0917
(248) 546-2110
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125070316
IL
208000000X
Pediatrics Physician
Primary
5101025276
MI
Other
Enumeration date
06/06/2017
Last updated
03/15/2021
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