Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 248571 | MA |
N | 208600000X | Surgeon | 248571 | MA |
N | 208200000X | Surgeon | DO40706 | SC |
N | 208600000X | Surgeon | DO40706 | SC |
N | 208200000X | Surgeon | OT012020 | PA |
N | 208600000X | Surgeon | OT012020 | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 40706 | SC |
NPI | 1093933467 |
---|---|
Provider Name | Barry Gibney |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 29/06/2017 |