Individual
SEAN EDWARD ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200501071
NC
208M00000X
Hospitalist Physician
Primary
2061599A
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10197163
—
VA
05
—
110089907A
—
MA
01
—
140K6
BCBS
—
01
—
182869
MEDCOST
—
05
—
3810003147
—
WV
05
—
5901865
—
NC
01
—
7701646
AETNA
—
01
—
806778
PARTNERS
—
05
—
Q0107D
—
SC
Enumeration date
09/21/2005
Last updated
04/25/2016
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