Individual
ERVIN ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10980 BUCKLEY HALL ROAD, BUILDING #5, MATHEWS, VA 23109-2310
(804) 725-9191
(804) 725-9120
Mailing address
PO BOX 866, MATHEWS, VA 23109-0866
(804) 725-9191
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME53345
FL
207Q00000X
Family Medicine Physician
Primary
0101034362
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049567100
—
FL
05
—
1114920253
—
VA
Enumeration date
05/23/2005
Last updated
05/31/2019
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