Provider Demographics
NPI:1235118654
Name:BATCHELOR, ERVIN SHERWOOD JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERVIN
Middle Name:SHERWOOD
Last Name:BATCHELOR
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 E 4TH ST
Mailing Address - Street 2:SUITE 702
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3260
Mailing Address - Country:US
Mailing Address - Phone:704-372-5997
Mailing Address - Fax:704-372-2330
Practice Address - Street 1:1718 E 4TH ST
Practice Address - Street 2:SUITE 702
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3260
Practice Address - Country:US
Practice Address - Phone:704-372-5997
Practice Address - Fax:704-372-2330
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1659103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000052Medicaid
NCR43817Medicare UPIN
NC2811646Medicare ID - Type Unspecified