Provider Demographics
NPI:1891704003
Name:ERWIN, ELEANOR A (MD)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:A
Last Name:ERWIN
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 1:460 MCLAWS CIR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5671
Mailing Address - Country:US
Mailing Address - Phone:757-221-7111
Mailing Address - Fax:757-221-8085
Practice Address - Street 1:301 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2833
Practice Address - Country:US
Practice Address - Phone:757-259-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239872207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010277060Medicaid
VAP00376806OtherRAILROAD MEDICARE
VA012302W57Medicare PIN