| Doctor Name: | DR. JEFFREY CLARK GERSBACH |
| NPI Number: | 1548274343 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 021585 |
| Business Practice Address: | 2645 Burden Creek Rd Johns Island, SC - 294554604 |
| Business Phone Number: | 8432240880 |
| Business Fax Number: | 4259448954 |
| Mailing Address: | 2645 Burden Creek Rd, JOHNS ISLAND |
| State: | SC |
| Postal Code: | 294554604 |
| Phone Number: | 8435591958 |
| Fax Number: | 8432257749 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 10/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 021585 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |