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Individual

DR. JOEL PETER GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
78013
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
043238282
AETNA
MA
01
12706
HEALTH NEW ENGLAND
MA
01
3147062
CIGNA
MA
01
4500254
AETNA
MA
01
747282
CONNECTICARE
MA
01
758399
TUFTS HEALTH PLANS
MA
01
J14217
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/24/2006
Last updated
02/10/2017
Update your record

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