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
Phone: (215) 887-5910
Fax: (215) 887-0387
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1689675449 | NPPES |
Pennsylvania | MEDICAID | 0015356250001 | |
Pennsylvania | Other | 7305038 | |
Pennsylvania | Other | 30002264 | |
Pennsylvania | Other | 0060610000 |
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