Individual
DR. GLEN R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2003 MEDICAL PKWY, SUITE 301, ANNAPOLIS, MD 21401-7992
(410) 266-9966
(410) 266-6819
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6538
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
D0062550
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BCBS
—
01
—
102077
JHHC
—
01
—
145726104
FEDERAL WORKMAN'S COMP (ANNE ARUNDEL MEDICAL CENTER)
—
01
—
1703604
AMERICHOICE
—
01
—
2137029
MAMSI
—
01
—
2363265
UNITED HEALTHCARE
—
01
—
254989
KAISER
—
01
—
287909
AMERIGROUP
—
01
—
3758040
CIGNA
—
01
—
3943260
AETNA HMO
—
05
—
407175105
—
MD
05
—
407972800
—
MD
01
—
610307700
FEDERAL WORKMANS COMP
—
01
—
64670901
BCBS
—
01
—
64670903
BCBS (HOS)
—
01
—
64670904
BCBS (HOS)
—
01
—
64670908
BCBS
—
01
—
7105042
AETNA PPO
—
01
—
K5850009
BCBS DC
—
Enumeration date
07/12/2005
Last updated
12/05/2013
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