Gordon, Carrie A

Gordon, Carrie A is an individual health care provider with primary practice located at 887 Congress St. Suite 320, Portland ME 04102. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is her primary health care specialty. Gordon, Carrie A can be contacted via phone (207) 662-5522.

Contact Information

Primary practice address
887 Congress St. Suite 320 Portland ME 04102
Phone: (207) 662-5522
Fax: (207) 662-5527
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD16227 Maine
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X MD16227 Maine

Profile Details

NPI number 1215020755
LBN Legal business name Gordon, Carrie A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Apr 26th, 2017 - 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 1215020755 NPPES
New Hampshire MEDICAID 30204313
New Hampshire MEDICAID 407810099

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