Provider Demographics
NPI:1174606917
Name:GIBBS, CAROL MINNETTE (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:MINNETTE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 NC HIGHWAY 55
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7812
Mailing Address - Country:US
Mailing Address - Phone:919-451-7870
Mailing Address - Fax:919-363-7697
Practice Address - Street 1:5306 NC HIGHWAY 55
Practice Address - Street 2:SUITE 105
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7812
Practice Address - Country:US
Practice Address - Phone:919-451-7870
Practice Address - Fax:919-363-7697
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC820502084P0800X
NC96013232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891234HMedicaid
H52916Medicare UPIN
NC891234HMedicaid