Gordon, Andrew John

Gordon, Andrew John is an individual health care provider with primary practice located at 601 John St Ste M-283 , Kalamazoo MI 49007-5382. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Gordon, Andrew John can be contacted via phone (269) 349-7696.

Contact Information

Primary practice address
601 John St Ste M-283 Kalamazoo MI 49007-5382
Phone: (269) 349-7696
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X AG067751 Michigan
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301067751 Michigan

Profile Details

NPI number 1194761924
LBN Legal business name Gordon, Andrew John
Credentials MD, FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jan 13th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194761924 NPPES
Michigan Other 020A312720 BCBSM GROUP ID
Michigan MEDICAID 4848964 BCBSM GROUP ID
Michigan MEDICAID 4227783 BCBSM GROUP ID

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