Gordon, Brian M
Gordon, Brian M is an individual health care provider with primary practice located at 790 Church St Ne Ste 400, Marietta GA 30060-7282. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gordon, Brian M can be contacted via phone (770) 952-8899.Contact Information
Primary practice address
790 Church St Ne Ste 400
Marietta GA 30060-7282
Phone: (770) 952-8899
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 048781 | Georgia |
Profile Details
| NPI number | 1083680326 |
|---|---|
| LBN Legal business name | Gordon, Brian M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2006 |
| Last updated | May 10th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083680326 | NPPES |
| Georgia | MEDICAID | 000880206 |
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