Provider Demographics
NPI:1013111988
Name:GORDON, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:GORDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PURPLE HEART AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER AIR FORCE BASE
Mailing Address - State:DE
Mailing Address - Zip Code:19902-5051
Mailing Address - Country:US
Mailing Address - Phone:302-346-8716
Mailing Address - Fax:
Practice Address - Street 1:115 PURPLE HEART AVE
Practice Address - Street 2:
Practice Address - City:DOVER AIR FORCE BASE
Practice Address - State:DE
Practice Address - Zip Code:19902-5051
Practice Address - Country:US
Practice Address - Phone:302-346-8716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01946207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology