George W Gibson Do Pc | |
15201 W Mcnichols Rd Detroit MI 48235-3717 | |
(313) 930-0242 | |
(734) 451-0603 |
Full Name | George W Gibson Do Pc |
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Speciality | Family Medicine |
Location | 15201 W Mcnichols Rd, Detroit, Michigan |
Authorized Official Name and Position | George W Gibson (OWNER) |
Authorized Official Contact | 3139300242 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
George W Gibson Do Pc 15201 W Mcnichols Rd Detroit MI 48235-3717 Ph: (313) 930-0242 | George W Gibson Do Pc 15201 W Mcnichols Rd Detroit MI 48235-3717 Ph: (313) 930-0242 |
NPI Number | 1912264045 |
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Provider Enumeration Date | 04/13/2012 |
Last Update Date | 04/13/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912264045 | NPI | - | NPPES |
5101006424 | Other | MI | PENDING |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5101006424 (Michigan) | Primary |
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