Gibson, Gregory David

Gibson, Gregory David is an individual health care provider with primary practice located at 29520 Canvasback Dr , Easton MD 21601-7124. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Gibson, Gregory David can be contacted via phone (410) 822-5007.

Contact Information

Primary practice address
29520 Canvasback Dr Easton MD 21601-7124
Fax: (410) 822-5569
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X Maryland

Profile Details

NPI number 1386863330
LBN Legal business name Gibson, Gregory David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Feb 20th, 2015 - about 10 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 1386863330 NPPES
Maryland MEDICAID 609500303
Maryland MEDICAID 609550001
Maryland MEDICAID 609550004
Maryland Other LM49EA
Maryland Other R968
Maryland Other 517251
Maryland MEDICAID 609550002
Maryland MEDICAID 609500300
Maryland Other 259147000
Maryland MEDICAID 609500301

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