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Contact Information

GLEN R GIBSON, MD
2003 MEDICAL PKWY
SUITE 301
ANNAPOLIS, MD21401-7992
 Phone: 410-266-9966
 Fax: 410-266-6819
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Oncology

2086X0206X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GLEN R GIBSON · (Male)

NPI # 1609874973
Status Active
Credentials MD
Entity Individual
Enumeration date 07/12/2005
Last updated 12/05/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MD License # D0062550
  • MD Medicaid 407175105
  • MD Medicaid 407972800
  • Other 3943260 AETNA HMO
  • Other 7105042 AETNA PPO
  • Other 1703604 AMERICHOICE
  • Other 287909 AMERIGROUP
  • Other 0001 BCBS
  • Other 64670901 BCBS
  • Other 64670908 BCBS
  • Other 64670903 BCBS (HOS)
  • Other 64670904 BCBS (HOS)
  • Other K5850009 BCBS DC
  • Other 3758040 CIGNA
  • Other 145726104 FEDERAL WORKMAN'S COMP (ANNE ARUNDEL MEDICAL CENTER)
  • Other 610307700 FEDERAL WORKMANS COMP
  • Other 102077 JHHC
  • Other 254989 KAISER
  • Other 2137029 MAMSI
  • Other 2363265 UNITED HEALTHCARE
Hospital affiliation(s)
  • ANNE ARUNDEL MEDICAL CENTER - (Acute Care)
    2001 MEDICAL PARKWAY
    ANNAPOLIS, MD 21401
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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