Individual
VALDA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3725 RENEE DR, MYRTLE BEACH, SC 29579-4109
(843) 350-1124
(877) 452-8854
Mailing address
3725 RENEE DR, MYRTLE BEACH, SC 29579-4109
(843) 350-1124
(877) 452-8854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
030411
GA
207R00000X
Internal Medicine Physician
Primary
91826
SC
208M00000X
Hospitalist Physician
Primary
030411
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000669094E
—
GA
05
—
918261
—
SC
Enumeration date
07/12/2006
Last updated
03/26/2026
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