Individual
MICHAEL P GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M-3046
ID
2083X0100X
Occupational Medicine Physician
Primary
M3046
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003716100
—
ID
Enumeration date
06/15/2006
Last updated
12/31/2008
Update your record
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