Individual
MICHAEL A GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 DENNIS DRIVE, SANFORD, NC 27330
(919) 774-2220
Mailing address
117 DENNIS DRIVE, SANFORD, NC 27330
(919) 774-2220
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
13991
NC
2086S0129X
Vascular Surgery Physician
13991
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0170C
BCBS
—
05
—
8936308
—
NC
Enumeration date
01/10/2006
Last updated
07/21/2022
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