Organization
WILLIE B GIBSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL L FOSTER (OFFICE MANAGER)
(313) 535-9366
Entity
Organization
Contact information
Practice address
18300 W MCNICHOLS RD, DETROIT, MI 48219-4162
(313) 535-9366
(313) 534-1970
Mailing address
18300 W MCNICHOLS RD, DETROIT, MI 48219-4162
(313) 535-9366
(313) 534-1970
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301035487
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098127
—
MI
Enumeration date
12/21/2009
Last updated
06/23/2010
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