Healthcare Provider Details

I. General information

NPI: 1700847365
Provider Name (Legal Business Name): STEVEN F GORDON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/17/2024
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4614 WILLIAM PENN HWY
MURRYSVILLE PA
15668-2004
US

IV. Provider business mailing address

600 GRANT ST
PITTSBURGH PA
15219-2702
US

V. Phone/Fax

Practice location:
  • Phone: 712-252-2477
  • Fax: 712-252-5516
Mailing address:
  • Phone: 724-733-1414
  • Fax: 712-252-5516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25474
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD444514
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: