Individual
DR. ETHAN BENJAMIN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1575 CONCENTRIC BLVD, SAGINAW, MI 48604-9311
(989) 746-7766
Mailing address
102 N WASHINGTON AVE APT 503, SAGINAW, MI 48607-1298
(847) 707-0413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4351053528
MI
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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