MEDICARE: CAROL MINNETTE GIBBS MD

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
1	2084P0800X	Psychiatry Physician	0101282680	VA
2	2084P0800X	Psychiatry Physician	82050	SC
3	2084P0800X	Psychiatry Physician	9601323	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174606917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MINNETTE GIBBS MD

Provider Business Mailing Address
First Line	:	5306 NC HIGHWAY 55
Second Line	:	SUITE 105
City	:	DURHAM
State	:	NC
Zip	:	27713-7812
Country	:	US
Telephone Number	:	919-451-7870
Fax Number	:	919-363-7697

Provider Business Practice Location Address
First Line	:	5306 NC HIGHWAY 55
Second Line	:	SUITE 105
City	:	DURHAM
State	:	NC
Zip	:	27713-7812
Country	:	US
Telephone Number	:	919-451-7870
Fax Number	:	919-363-7697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	03/24/2026

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Directions to “ CAROL MINNETTE GIBBS MD” Practice Location

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