Provider Demographics
NPI:1295042489
Name:BIRCHETTE, WILLIAM IV
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:BIRCHETTE
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 WINNSBORO DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2162
Mailing Address - Country:US
Mailing Address - Phone:301-518-3032
Mailing Address - Fax:
Practice Address - Street 1:7909 WINNSBORO DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2162
Practice Address - Country:US
Practice Address - Phone:301-518-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0002473055347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle