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General NPI Number Information
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NPI Number | 1013925783
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Entity Type | Individual
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Provider Name | STEVEN MARK GORDON PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 8945 GUILFORD RD STE 140
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City | COLUMBIA
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State | MD
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Zip | 21046-2659
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Country | US
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Telephone | 410-988-2503
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Fax | 410-343-7899
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Provider Business Mailing Address
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Address Line | 8945 GUILFORD RD STE 140
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City | COLUMBIA
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State | MD
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Zip | 21046-2659
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Country | US
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Telephone | 410-988-2503
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Fax | 410-343-7899
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R144658
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License Number State | MD
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