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General NPI Number Information
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NPI Number | 1700861374
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Entity Type | Individual
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Provider Name | KIM F GIBSON MD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE EXECUTIVE HEALTH, NNMC
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-319-8334
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Fax | 301-295-2433
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Provider Business Mailing Address
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Address Line | 5709 NEWINGTON RD
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City | BETHESDA
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State | MD
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Zip | 20816-1281
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Country | US
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Telephone | 301-275-2426
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101039533
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0096709
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License Number State | MD
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