Provider Demographics
NPI:1346350030
Name:ERSKINE, GERALD MARSHALL (DPM)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:MARSHALL
Last Name:ERSKINE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 SENECA TRL
Mailing Address - Street 2:219 NORTH
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-1320
Mailing Address - Country:US
Mailing Address - Phone:304-645-0200
Mailing Address - Fax:304-645-0240
Practice Address - Street 1:336 SENECA TRL
Practice Address - Street 2:219 NORTH
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1320
Practice Address - Country:US
Practice Address - Phone:304-645-0200
Practice Address - Fax:304-645-0240
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00350213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVT89098Medicare UPIN
WV0624480001Medicare NSC