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NPI Code Detail

MEDICARE: MARGARET GIBSON O.D.

MEDICARE: MARGARET GIBSON O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristTUV006804-1NY

General Provider Information

NPI Number : 1992785349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET GIBSON O.D.
Provider Business Mailing Address
First Line : 1623 DRYDEN WAY
Second Line :
City : CROFTON
State : MD
Zip : 21114-1410
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 WOOD RD
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21402-1257
Country : US
Telephone Number : 410-293-1130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 08/22/2007

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