Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD064217L | PA |
NPI | 1487761052 |
---|---|
Provider Name | Dr. Adam Joseph Gordon |
First Address | Pittsburgh, PA 15240-0000 |
Second Address | Pittsburgh, PA 15240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |