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NPI Code Detail

MEDICARE: ROBERT D GORDON MD

MEDICARE: ROBERT D GORDON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician5691NH

General Provider Information

NPI Number : 1952485443
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT D GORDON MD
Provider Business Mailing Address
First Line : 696 DANIEL WEBSTER HWY
Second Line :
City : MERRIMACK
State : NH
Zip : 03054-2748
Country : US
Telephone Number : 603-429-3155
Fax Number : 603-424-8693
Provider Business Practice Location Address
First Line : 696 DANIEL WEBSTER HWY
Second Line :
City : MERRIMACK
State : NH
Zip : 03054-2748
Country : US
Telephone Number : 603-429-3155
Fax Number : 603-424-8693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 04/15/2009

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Directions to “ ROBERT D GORDON MD” Practice Location

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