Gibbons, Michael Anthony

Gibbons, Michael Anthony is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gibbons, Michael Anthony can be contacted via phone (218) 786-8364.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 38183 Minnesota

Profile Details

NPI number 1417989401
LBN Legal business name Gibbons, Michael Anthony
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated May 10th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417989401 NPPES
Minnesota MEDICAID 323216600
Minnesota MEDICAID 32151900

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