Healthcare Provider Details

I. General information

NPI: 1255625430
Provider Name (Legal Business Name): SARAH MARGARET GORDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2011
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

10704 MIST HAVEN TER
ROCKVILLE MD
20852-3437
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD93683
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD-16976
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number21140
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: