Individual
MARK R GORDON
Active
Individual
MARK R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
3929
SD
207RC0000X
Cardiovascular Disease Physician
5823A
WY
207RC0000X
Cardiovascular Disease Physician
Primary
G-168143
CA
207RC0000X
Cardiovascular Disease Physician
MD2020-0673
NM
207RC0000X
Cardiovascular Disease Physician
MD220295
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008426
SD BCBS
SD
05
—
0549402
—
IA
01
—
101T6GO
MN BCBS - PLAN 91057NO
MN
01
—
10492
HEALTHPARTNERS
—
01
—
165025
UCARE
MN
01
—
25-00667
MEDICA SELECTCARE
—
05
—
331503700
—
MN
01
—
33333
IA BCBS #
IA
01
—
346L9GO
MN BCBS - PLAN 538R2NO
MN
01
—
3929
DAKOTACARE
SD
05
—
6002892
—
SD
01
—
931451030123
PREFERRED ONE
—
Enumeration date
05/04/2006
Last updated
06/27/2025
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