Basic Information
| Provider Information | |||||||||
| NPI: | 1922043165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KERSCHL | ||||||||
| FirstName: | WALTER | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 388 | ||||||||
| Address2: | |||||||||
| City: | FISHERSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229390388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409324629 | ||||||||
| FaxNumber: | 5409325875 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 COMFORT WAY | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244503788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404633381 | ||||||||
| FaxNumber: | 5404633477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 12/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101051481 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 005878250 | 05 | VA | MEDICAID | 010206839 | 05 | VA | MEDICAID |