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:
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Health care specialties

SpecialtyCodeLicense #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 7 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 1235124777 NPPES
Indiana MEDICAID 100365270

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