| James A. Gibson, M.d., P.c. | |
|
5784 Highland Rd Waterford MI 48327-1876 | |
| (248) 673-6667 | |
| (248) 673-7224 |
| Full Name | James A. Gibson, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5784 Highland Rd, Waterford, Michigan |
| Authorized Official Name and Position | Rene S Gibson (OFFICE MANAGER) |
| Authorized Official Contact | 2484318592 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James A. Gibson, M.d., P.c. 5784 Highland Rd Waterford MI 48327-1876 Ph: (248) 673-6667 | James A. Gibson, M.d., P.c. 5784 Highland Rd Waterford MI 48327-1876 Ph: (248) 673-6667 |
| NPI Number | 1285828095 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 10/27/2010 |
| Medicare PECOS PAC ID | 5890685499 |
|---|---|
| Medicare Enrollment ID | O20040317001225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285828095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301065590 (Michigan) | Primary |
| Provider Name | James A Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104838655 PECOS PAC ID: 8426947896 Enrollment ID: I20040407000866 |
| Provider Name | Rochelle Lenetta Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184083974 PECOS PAC ID: 9638459761 Enrollment ID: I20161207002326 |
| Provider Name | Joey Sheroski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306576871 PECOS PAC ID: 7911376736 Enrollment ID: I20221221000941 |
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