Gibson, Mark R.

Gibson, Mark R. is an individual health care provider with primary practice located at 80 Mahalani St , Wailuku HI 96793-2531. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gibson, Mark R. can be contacted via phone (808) 243-6000.

Contact Information

Primary practice address
80 Mahalani St Wailuku HI 96793-2531
Phone: (808) 243-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 227243 Massachusetts
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD-17283 Hawaii

Profile Details

NPI number 1730107038
LBN Legal business name Gibson, Mark R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated May 26th, 2021 - about 4 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 1730107038 NPPES
Massachusetts MEDICAID 2118815

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