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Individual

BRUCE ROBERT GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
4940 EASTERN AVE, A5E, BALTIMORE, MD 21224-2735

Taxonomy

Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D64840
MD
208600000X
Surgery Physician
Primary
D64840
MD

Other

Enumeration date
08/01/2006
Last updated
04/06/2010
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