Provider Demographics
NPI:1700847365
Name:GORDON, STEVEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
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 1:600 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-2702
Mailing Address - Country:US
Mailing Address - Phone:724-733-1414
Mailing Address - Fax:712-252-5516
Practice Address - Street 1:4614 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-2004
Practice Address - Country:US
Practice Address - Phone:712-252-2477
Practice Address - Fax:712-252-5516
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25474207Q00000X
PAMD444514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9216093OtherDAKOTA CARE
SD20200OtherSIOUX VALLEY
NE75305796313Medicaid
75305796351106B004OtherTRICARE
IA1042259Medicaid
199OtherMIDLANDS CHOICE
IA47475OtherWELLMARK BCBS
SD7783912Medicaid
IA1042259Medicaid
IAI7036Medicare ID - Type Unspecified
NE75305796313Medicaid