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Individual
WILLIAM P FITZGIBBONS
Active
Individual
WILLIAM P FITZGIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15830
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0903302
MEDIPASS
—
01
—
1265405617
NPI
—
01
—
15830
LICENSE
NE
01
—
470710146
TAX I D
—
05
—
470710146-13
—
NE
Enumeration date
02/08/2006
Last updated
03/07/2023
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