Provider Demographics
NPI:1326459157
Name:GIBBS, NEVILLE (MD)
Entity Type:Individual
Prefix:
First Name:NEVILLE
Middle Name:
Last Name:GIBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BLAIR MILL RD
Mailing Address - Street 2:PH #2
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4862
Mailing Address - Country:US
Mailing Address - Phone:202-882-0189
Mailing Address - Fax:
Practice Address - Street 1:1220 BLAIR MILL RD
Practice Address - Street 2:PH #2
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4862
Practice Address - Country:US
Practice Address - Phone:202-882-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC13023273100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273100000XHospital UnitsEpilepsy Unit