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Jeremy Gordon
NPI 1780036525 · on the registry since 2016
Practice
- Address
- 30209 Westwood Dr
Madison Heights, MI 48071 - Phone
- (248) 250-2388
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Also registered as
- 225X00000X
- Licence states on file
- TX, CO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-07-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan