Gordon, Fredric D
Gordon, Fredric D is an individual health care provider with primary practice located at 800 Washington St Bldg 40 , Boston MA 02111-1552. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Hepatology. Allopathic & Osteopathic Physicians / Hepatology is his primary health care specialty. Gordon, Fredric D can be contacted via phone (617) 636-4886.Contact Information
Primary practice address
800 Washington St Bldg 40
Boston MA 02111-1552
Phone: (617) 636-4886
Fax: (617) 636-1003
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 73902 | Massachusetts |
| Allopathic & Osteopathic Physicians / Hepatology | 207RI0008X | 73902 | Massachusetts |
Profile Details
| NPI number | 1891892691 |
|---|---|
| LBN Legal business name | Gordon, Fredric D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Mar 17th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891892691 | NPPES |
| Massachusetts | MEDICAID | 3133745 | |
| Massachusetts | MEDICAID | 110055325A |
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