Willie B Gibson MD PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

4301035487 Issued in MI

Legal business name

WILLIE B GIBSON MD PC

Practice address

18300 W McNichols Rd
Detroit, MI 48219-4162

Phone

(313) 535-9366

Fax

(313) 534-1970

NPI assigned

Dec 21, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheryl L Foster

Title

Office Manager

Phone

(313) 535-9366

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1043549181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194162",
            "telephone_number": "313-535-9366",
            "fax_number": "313-534-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194162",
            "telephone_number": "313-535-9366",
            "fax_number": "313-534-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIE B GIBSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-535-9366"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301035487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1098127",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Failica Renee Williamson, C.O.T.A.
• Gloria Williamson
• Ronald Frederick Williamson, MD
• Sean R Williamson, M.D
• Tinelda Williamson
• Micah Willimas
• Lawanda Willinham
• Allie Willis, AT, ATC
• Daishia Willis
• Donna Willis

• Endocrinology, Diabetes & Metabolism Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.