| Doctor Name: | DR. SEAN L. GIBBS |
| NPI Number: | 1215010020 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 28519 |
| Business Practice Address: | 606 Black River Rd Georgetown, SC - 294403304 |
| Business Phone Number: | 8435208456 |
| Business Fax Number: | |
| Mailing Address: | 3816 Highway 17 South, NORTH MYRTLE BEACH |
| State: | SC |
| Postal Code: | 29582 |
| Phone Number: | 8432721411 |
| Fax Number: | 8432722130 |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 09/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 28519 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |