Provider Demographics
NPI:1982639043
Name:GORDON, CHRISTOPHER DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:GORDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 CLARKS HL
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8172
Mailing Address - Country:US
Mailing Address - Phone:508-628-6652
Mailing Address - Fax:508-861-0933
Practice Address - Street 1:1881 WORCESTER ROAD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-628-6652
Practice Address - Fax:508-861-0933
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA408332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C46332Medicare UPIN