MEDICARE: ANNIE CLAUDE GERSH D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2009-00139	NC
2	207Q00000X	Family Medicine Physician	1644	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801923560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE CLAUDE GERSH D.O.

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 W GEORGIA RD
Second Line	:	SUITE B
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-6419
Country	:	US
Telephone Number	:	864-454-5000
Fax Number	:	864-454-5005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	05/14/2021

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