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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083680326 NPPES
Georgia MEDICAID 000880206

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