Provider Demographics
NPI:1730322819
Name:BUTCHO, ERIN MARIE HAMILTON (MD)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MARIE HAMILTON
Last Name:BUTCHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-1631
Mailing Address - Country:US
Mailing Address - Phone:304-728-1600
Mailing Address - Fax:
Practice Address - Street 1:300 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-1631
Practice Address - Country:US
Practice Address - Phone:304-728-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV244872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810029895Medicaid
WVWV5542B987Medicare PIN