Provider Demographics
NPI:1295800092
Name:ERWIN, DAVID H (MSPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:ERWIN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E BOBBY GERALD PKWY
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-3048
Mailing Address - Country:US
Mailing Address - Phone:843-423-4474
Mailing Address - Fax:843-423-4478
Practice Address - Street 1:110 PALMETTO POINTE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6722
Practice Address - Country:US
Practice Address - Phone:843-423-4474
Practice Address - Fax:843-423-4478
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC4233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1173Medicaid
SCSC4233OtherSTATE LICENSE