Provider Demographics
NPI:1316939473
Name:ERVIN, FRANK RICHARD (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:RICHARD
Last Name:ERVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 FAIRFAX RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5606
Mailing Address - Country:US
Mailing Address - Phone:843-665-1508
Mailing Address - Fax:
Practice Address - Street 1:1410 FAIRFAX RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5606
Practice Address - Country:US
Practice Address - Phone:843-665-1508
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8298207R00000X, 207RI0200X, 207ZM0300X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Not Answered207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8298OtherPHYSICIAN LICENSE NUMBER
SC8298OtherPHYSICIAN LICENSE NUMBER
SCAE7499230OtherSTATE DEA LICENSE NUMBER
D09206Medicare UPIN