| George W Gibson DO PC | |
|
15201 W Mcnichols Rd Detroit MI 48235-3717 | |
| (313) 930-0242 | |
| (734) 451-0603 |
| Full Name | George W Gibson DO PC |
|---|---|
| Speciality | Family Medicine |
| Location | 15201 W Mcnichols Rd, Detroit, Michigan |
| Authorized Official Name and Position | George W Gibson (OWNER) |
| Authorized Official Contact | 3139300242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| George W Gibson DO PC 15201 W Mcnichols Rd Detroit MI 48235-3717 Ph: (313) 930-0242 | George W Gibson DO PC 15201 W Mcnichols Rd Detroit MI 48235-3717 Ph: (313) 930-0242 |
| NPI Number | 1912264045 |
|---|---|
| Provider Enumeration Date | 04/13/2012 |
| Last Update Date | 04/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912264045 | NPI | - | NPPES |
| 5101006424 | Other | MI | PENDING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101006424 (Michigan) | Primary |
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