Individual
FREDRIC D GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 WASHINGTON ST BLDG 40, BOSTON, MA 02111-1552
(617) 636-4886
(617) 636-1003
Mailing address
168 CYNTHIA RD, NEWTON, MA 02459-2864
(617) 291-3960
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
73902
MA
207RI0008X
Hepatology Physician
Primary
73902
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110055325A
—
MA
05
—
3133745
—
MA
Enumeration date
09/20/2006
Last updated
03/17/2025
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