Gordon, Peter H

Gordon, Peter H is an individual health care provider with primary practice located at 235 N Pearl St Radiology Department, Brockton MA 02301-1794. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gordon, Peter H can be contacted via phone (508) 427-3106.

Contact Information

Primary practice address
235 N Pearl St Radiology Department Brockton MA 02301-1794
Fax: (508) 427-2538
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 043015 Massachusetts

Profile Details

NPI number 1679525141
LBN Legal business name Gordon, Peter H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jul 8th, 2007 - 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 1679525141 NPPES
Massachusetts MEDICAID 0114057

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