Organization
CRAIG J GORDON, D.O., P.C.
Active
Other names
Clinical Oncology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE HUDEL (PRACTICE MANAGER)
(248) 522-0222
Entity
Organization
Contact information
Practice address
30160 ORCHARD LAKE RD STE 100, FARMINGTON HILLS, MI 48334-2254
(248) 522-0222
(248) 522-0225
Mailing address
30160 ORCHARD LAKE RD STE 100, FARMINGTON HILLS, MI 48334-2254
(248) 522-0222
(248) 522-0225
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
CG008584
MI
207RH0003X
Hematology & Oncology Physician
Primary
SS065453
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404140
—
MI
01
—
5679150
AETNA
MI
01
—
OF37505
BCBS
MI
01
—
P6078
BCN
MI
01
—
P88665
BCN
MI
Enumeration date
10/31/2005
Last updated
06/04/2019
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