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Individual

GREGORY DAVID GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
29520 CANVASBACK DR, EASTON, MD 21601-7124
(410) 822-5007
(410) 822-5569
Mailing address
2336 GODDARD PARKWAY, SALISBURY, MD 21801
(410) 334-6961
(410) 334-6362

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
259147000
MAGELLAN GROUP
MD
01
517251
UHC MAMSI GROUP
05
609500300
MD
05
609500301
MD
05
609500303
MD
05
609550001
MD
05
609550002
MD
05
609550004
MD
01
LM49EA
CAREFIRST BCBS GROUP
MD
01
R968
CAREFIRST FEDERAL GROUP
Enumeration date
04/25/2007
Last updated
02/20/2015
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