Gibson, Glen R

Gibson, Glen R is an individual health care provider with primary practice located at 2003 Medical Pkwy Suite 301, Annapolis MD 21401-7992. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as his primary health care specialty. Gibson, Glen R can be contacted via phone (410) 266-9966.

Contact Information

Primary practice address
2003 Medical Pkwy Suite 301 Annapolis MD 21401-7992
Phone: (410) 266-9966
Fax: (410) 266-6819
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X D0062550 Maryland

Profile Details

NPI number 1609874973
LBN Legal business name Gibson, Glen R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Dec 5th, 2013 - about 11 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 1609874973 NPPES
Other 2137029 MAMSI
Other 64670901 MAMSI
Other 64670903 MAMSI
Other K5850009 MAMSI
Other 102077 MAMSI
Other 1703604 MAMSI
Other 2363265 MAMSI
Other 3758040 MAMSI
Other 3943260 MAMSI
MEDICAID 407175105 MAMSI
Other 254989 MAMSI
Other 7105042 MAMSI
Other 287909 MAMSI
Other 145726104 MAMSI
Other 64670908 MAMSI
MEDICAID 407972800 MAMSI
Other 610307700 MAMSI
Other 0001 MAMSI
Other 64670904 MAMSI

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