Individual
DR. LARRY M GERSTENHABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5617 MAXWELL PL, WILMINGTON, NC 28409-2966
(910) 742-9243
(888) 746-1787
Mailing address
PO BOX 16310, WILMINGTON, NC 28408-6310
(910) 742-9243
(888) 746-1787
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
0493
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03610
BCBS
NC
01
—
2821555C
MEDICARE-UNSPECIFIED
NC
05
—
6000665
—
NC
Enumeration date
08/14/2006
Last updated
11/29/2018
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