Provider Demographics
NPI:1801980404
Name:GORDES, KAREN LYNN (DSCPT, PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:GORDES
Suffix:
Gender:F
Credentials:DSCPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PENN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1082
Mailing Address - Country:US
Mailing Address - Phone:410-706-7720
Mailing Address - Fax:
Practice Address - Street 1:100 PENN ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1082
Practice Address - Country:US
Practice Address - Phone:410-706-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD192692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic