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General NPI Number Information
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NPI Number | 1699254292
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Entity Type | Organization
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Legal Business Name | STEVEN M GORDON LLC
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 07/17/2025
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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 | 8730 GEORGIA AVE STE 312
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City | SILVER SPRING
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State | MD
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Zip | 20910-3650
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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 | OWNER
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Name | STEVEN MARK GORDON
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Credential | CRNP
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Telephone | 410-988-2503
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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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