Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | C1-0004905 | DE |
N | 208600000X | Surgeon | C1-0004905 | DE |
Y | 2086S0102X | Surgical Critical Care | C10004905 | DE |
NPI | 1245215979 |
---|---|
Provider Name | Frederick A Giberson |
First Address | Wilmington, DE 19805-7170 |
Second Address | Newark, DE 19713-2072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 29/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G47971 | (02) | DE |