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Individual

MARIA V GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5916 E MCKELLIPS RD, MESA, AZ 85215-2755
(480) 930-4477
Mailing address
5916 E MCKELLIPS RD, MESA, AZ 85215-2755
(480) 930-4477

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23088
SC
207Q00000X
Family Medicine Physician
Primary
53596
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
230887
SC
Enumeration date
08/29/2006
Last updated
04/13/2020
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