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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992296818 NPPES
Texas Other 426932602 CSHCN
Texas MEDICAID 426932601 CSHCN

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