Provider Demographics
NPI:1740593300
Name:GUNSELMAN, GENE (RPH)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:GUNSELMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 MAGNOLIA MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7562
Mailing Address - Country:US
Mailing Address - Phone:843-216-7765
Mailing Address - Fax:
Practice Address - Street 1:1220 BEN SAWYER BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4581
Practice Address - Country:US
Practice Address - Phone:843-884-3261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist