Individual
DR. JEFFREY CLARK GERSBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2645 BURDEN CREEK RD, JOHNS ISLAND, SC 29455-4604
(843) 224-0880
(425) 944-8954
Mailing address
2645 BURDEN CREEK RD, JOHNS ISLAND, SC 29455-4604
(843) 559-1958
(843) 225-7749
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
021585
SC
207P00000X
Emergency Medicine Physician
Primary
0101042360
VA
207P00000X
Emergency Medicine Physician
14843
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010653103
PRIVATE INSURANCE
SC
01
—
010653103003
BCBS
SC
05
—
148432 GP4105
—
SC
Enumeration date
07/28/2006
Last updated
02/27/2021
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