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General NPI Number Information
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NPI Number | 1689780579
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Entity Type | Individual
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Provider Name | KAREN E MCGIBBON MD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3028 BRIGHTSEAT ROAD #104
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City | LANHAM
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State | MD
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Zip | 20706
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Country | US
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Telephone | 301-772-6905
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Fax | 301-772-6908
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Provider Business Mailing Address
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Address Line | 9440 PENNSYLVANIA AVENUE #160
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-3687
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Country | US
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Telephone | 301-599-0460
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Fax | 301-599-0463
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0052176
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License Number State | MD
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