Provider Demographics
NPI:1922043165
Name:KERSCHL, WALTER CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:CHARLES
Last Name:KERSCHL
Suffix:
Gender:M
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-4629
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:55 COMFORT WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3788
Practice Address - Country:US
Practice Address - Phone:540-463-3381
Practice Address - Fax:540-463-3477
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051481207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005878250Medicaid
VA010206839Medicaid
110006287Medicare PIN
VAGC1100Medicare PIN
G19298Medicare UPIN
VA00V008P76Medicare PIN