Individual
GERSHOM JACOB DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
1506 N LIMESTONE ST STE B, GAFFNEY, SC 29340-4747
(864) 489-4498
Mailing address
1506 N LIMESTONE ST STE B, GAFFNEY, SC 29340-4747
(864) 489-4498
(803) 328-3806
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1135733
WI
363L00000X
Nurse Practitioner
Primary
27568
SC
Other
Enumeration date
10/07/2021
Last updated
09/14/2023
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