Individual
MELISA GAIL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
28 CENTRE DR, MILTON, VT 05468-3104
(802) 847-4322
Mailing address
28 CENTRE DR, MILTON, VT 05468-3104
(802) 847-4322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0011370
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014094
—
VT
Enumeration date
05/09/2007
Last updated
06/30/2009
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