Individual
DR. MARK B GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 PARK AVE, BALTIMORE, MD 21201-3416
(410) 752-1677
(410) 752-4435
Mailing address
100 PARK AVE, BALTIMORE, MD 21201-3416
(410) 752-1677
(410) 752-4435
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA0633
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522190
BCBS
MD
01
—
S017-0006
BLUECHOICE
MD
Enumeration date
07/03/2006
Last updated
03/21/2008
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