Provider Demographics
NPI:1275895625
Name:GIBBS, HEATHER NICOLE (MD)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:NICOLE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:33663 BAYVIEW MEDICAL DR.
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-645-9325
Mailing Address - Fax:302-644-1203
Practice Address - Street 1:33663 BAYVIEW MEDICAL DRIVE
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-645-9325
Practice Address - Fax:302-644-1203
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0012483207RG0100X
SCLL34717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine