DR. WILLIE B GIBSON MD NPI 1497801609

NPI Information

NPI: 1497801609
Provider Name: DR. WILLIE B GIBSON, MD
Classification: Internal Medicine - 207RE0101X
Entity Type: Individual

Specialization: Endocrinology, Diabetes & Metabolism

PECOS Registration: Yes

Address:
18300 W MCNICHOLS RD
DETROIT, MI
ZIP 48219
Phone: (313) 535-9366
Get Directions

DR. Willie B Gibson, MD is an endocrinology and diabetes and metabolism internal medicine in Detroit, MI. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. DR. Willie B Gibson, MD NPI is 1497801609. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18300 W MCNICHOLS RD
DETROIT, MI
ZIP 48219-162
Phone: (313) 535-9366
Fax: (313) 534-1970

The NPI 1497801609 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/28/2007 and was last updated on 12/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	4301035487	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1098127	MEDICAID	MICHIGAN
2	A74504	MEDICARE UPIN	MICHIGAN
3	0823880	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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