Provider Demographics
NPI:1407550585
Name:ERLEWINE, RICHARD CHASE
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHASE
Last Name:ERLEWINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 NORTHSIDE DR STE 16
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-2036
Mailing Address - Country:US
Mailing Address - Phone:681-355-0411
Mailing Address - Fax:
Practice Address - Street 1:846 NORTHSIDE DR STE 16
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-2036
Practice Address - Country:US
Practice Address - Phone:681-355-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1107237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist