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Individual

DR. CHAD R. GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
DEPARTMENT OF PLASTIC SURGERY JOHNS HOPKINS, JHOC #8152F, 601 N. CAROLINE STREET, BALTIMORE, MD 21287-0001
(443) 287-6425
Mailing address
601 N. CAROLINE STREET, JHOC #8152F, DEPARTMENT OF PLASTIC SURGERY, JOHNS HOPKINS UNIVERSITY, BALTIMORE, MD 21287
(443) 287-6425

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
242456
MA
208200000X
Plastic Surgery Physician
Primary
H72202
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
242456
MASSACHUSETTS STATE LICENSE
MA
05
52189
MD
01
MB07654400
NEW JERSEY LICENSE NUMBER
NJ
Enumeration date
11/30/2007
Last updated
10/11/2019
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