Healthcare Provider Details

I. General information

NPI: 1376126482
Provider Name (Legal Business Name): DARNELL DONALD GORDON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0002
US

IV. Provider business mailing address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0002
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-6100
  • Fax:
Mailing address:
  • Phone: 202-865-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number61190
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD500002463
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0101625
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57.250601
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: