Provider Demographics
NPI:1720048333
Name:GIBBS, MICHAEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
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 1:1340 HAL GREER BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-526-2000
Mailing Address - Fax:
Practice Address - Street 1:4 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1626
Practice Address - Country:US
Practice Address - Phone:304-736-4000
Practice Address - Fax:304-736-4751
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0054296000Medicaid
WV7338241OtherMEDICARE PIN - CABELL HUNTINGTON HOSPITAL
WV7338241OtherMEDICARE PIN - CABELL HUNTINGTON HOSPITAL
WVWV2727B662Medicare Oscar/Certification
WV0054296000Medicaid
WVWV2727HMedicare Oscar/Certification
WVWV2727FMedicare Oscar/Certification
WVWV2727CMedicare Oscar/Certification
WVWV2727EMedicare Oscar/Certification
WVWV2727BMedicare Oscar/Certification
WVWV2727AMedicare Oscar/Certification
WVWV2727DMedicare Oscar/Certification
WVWV2727GMedicare Oscar/Certification