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NPI Code Detail

MEDICARE: DR. MICHAEL D GORDON MD

MEDICARE: DR. MICHAEL D GORDON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician46004WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659330793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL D GORDON MD
Provider Business Mailing Address
First Line : 1218 W KILBOURN AVE
Second Line : SUITE 301
City : MILWAUKEE
State : WI
Zip : 53233-1330
Country : US
Telephone Number : 414-276-6000
Fax Number : 414-276-1758
Provider Business Practice Location Address
First Line : 1218 W KILBOURN AVE
Second Line : SUITE 301
City : MILWAUKEE
State : WI
Zip : 53233-1330
Country : US
Telephone Number : 414-276-6000
Fax Number : 414-276-1758
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2006
Last Update Date : 12/21/2009

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Directions to “ DR. MICHAEL D GORDON MD” Practice Location

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