Gordon, Gary M

Gordon, Gary M is an sole proprietor health care provider with primary practice located at 2285 Cross Rd , Glenside PA 19038-5023. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Gordon, Gary M can be contacted via phone (215) 887-5910.

Contact Information

Primary practice address
2285 Cross Rd Glenside PA 19038-5023
Fax: (215) 887-0387
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC001507L Pennsylvania

Profile Details

NPI number 1689675449
LBN Legal business name Gordon, Gary M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2005
Last updated Mar 18th, 2008 - about 17 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 1689675449 NPPES
Pennsylvania MEDICAID 0015356250001
Pennsylvania Other 7305038
Pennsylvania Other 30002264
Pennsylvania Other 0060610000

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