Individual
DR. MARY L. CAMPAGNA-GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6308 8TH AVE, SUITE 2000, KENOSHA, WI 53143-5031
(262) 653-5300
(262) 653-5412
Mailing address
6308 8TH AVE, SUITE 2000, KENOSHA, WI 53143-5031
(262) 653-5300
(262) 653-5412
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2008-01613
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629258132
—
WI
05
—
5911767
—
NC
05
—
N0161G
—
SC
Enumeration date
11/13/2007
Last updated
02/18/2014
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