Individual
DR. CARIN R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6543
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6543
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
70724
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094489
—
WI
Enumeration date
11/01/2006
Last updated
11/22/2021
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