Gordon, David Mark
Gordon, David Mark is an individual health care provider with primary practice located at 28455 Haggerty Rd Suite 200, Novi MI 48377-2982. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Gordon, David Mark can be contacted via phone (248) 893-3200.Contact Information
Primary practice address
28455 Haggerty Rd Suite 200
Novi MI 48377-2982
Phone: (248) 893-3200
Fax: (248) 893-2950
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 4301061245 | Michigan |
Profile Details
| NPI number | 1558359018 |
|---|---|
| LBN Legal business name | Gordon, David Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2005 |
| Last updated | Jul 10th, 2023 - about last year |
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 | 1558359018 | NPPES |
| Michigan | MEDICAID | 4258734 |
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