Healthcare Provider Details

I. General information

NPI: 1164833539
Provider Name (Legal Business Name): BRIDGET BALDAUFF GIBSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIDGET FAUSTINA BALDAUFF MD

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 WHITEFORD RD UNIT 1
YORK PA
17402-8992
US

IV. Provider business mailing address

2860 WHITEFORD RD UNIT 1
YORK PA
17402-8992
US

V. Phone/Fax

Practice location:
  • Phone: 717-815-2564
  • Fax: 717-714-2289
Mailing address:
  • Phone: 717-815-2564
  • Fax: 717-714-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38704
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD495046
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: