Organization
MEDPRIMARY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA V GIBSON MD, PHD, CPE, CEO (CEO)
(843) 619-2990
Entity
Organization
Contact information
Practice address
103B HARTH PL, SUMMERVILLE, SC 29485-8107
(843) 619-2990
Mailing address
1327 DEEP WATER DR, MT PLEASANT, SC 29464-7434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23088
SC
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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