Aeckersberg, Gina Larissa
Aeckersberg, Gina Larissa is an individual health care provider with primary practice located at 169 Ashley Ave Rm 202 , Charleston SC 29425-8905. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is her primary health care specialty. Aeckersberg, Gina Larissa can be contacted via phone (937) 272-4976.Contact Information
Primary practice address
169 Ashley Ave Rm 202
Charleston SC 29425-8905
Phone: (937) 272-4976
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 47374 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Nephrology | 2080P0210X | 89678 | South Carolina |
Profile Details
| NPI number | 1992296818 |
|---|---|
| LBN Legal business name | Aeckersberg, Gina Larissa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2018 |
| Last updated | May 2nd, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992296818 | NPPES |
| Texas | Other | 426932602 | CSHCN |
| Texas | MEDICAID | 426932601 | CSHCN |
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