Healthcare Provider Details

I. General information

NPI: 1922043165
Provider Name (Legal Business Name): WALTER CHARLES KERSCHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 COMFORT WAY SUITE 1
LEXINGTON VA
24450-3788
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-463-3381
  • Fax: 540-463-3477
Mailing address:
  • Phone: 540-932-4629
  • Fax: 540-932-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101051481
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: