Individual
BROOKE BENSON GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1112 N MAIN ST, SUMMERVILLE, SC 29483-7315
(843) 212-8080
(843) 212-8081
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 212-8080
(843) 212-8081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL34719
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34719
MEDICAL LICENSE
SC
Enumeration date
06/18/2012
Last updated
03/25/2024
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