Healthcare Provider Details

I. General information

NPI: 1306260468
Provider Name (Legal Business Name): NICHOLAS JAMES ERDLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 E WEST RD
MIDLOTHIAN VA
23114-3372
US

IV. Provider business mailing address

15300 E WEST RD
MIDLOTHIAN VA
23114-3372
US

V. Phone/Fax

Practice location:
  • Phone: 804-379-2414
  • Fax:
Mailing address:
  • Phone: 804-379-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101259181
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number91809
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number91809
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: