Gordon, Gregory S
Gordon, Gregory S is an sole proprietor health care provider with primary practice located at 8701 Broadway , Merrillville IN 46410-7035. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Gordon, Gregory S can be contacted via phone (219) 738-5510.Contact Information
Primary practice address
8701 Broadway
Merrillville IN 46410-7035
Phone: (219) 738-5510
Fax: (219) 738-6714
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01038358 | Indiana |
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 01038358 | Indiana |
Profile Details
NPI number | 1235124777 |
---|---|
LBN Legal business name | Gordon, Gregory S |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 12th, 2005 |
Last updated | Aug 1st, 2019 - about 6 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 | 1235124777 | NPPES |
Indiana | MEDICAID | 100365270 |
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