Provider Demographics
NPI:1851469639
Name:ECHARD, SHAWN P (DPM)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:P
Last Name:ECHARD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HUMPHREY ROAD
Mailing Address - Street 2:TWO PINEVIEW PLACE, SUITE 4
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-832-7880
Mailing Address - Fax:724-832-8172
Practice Address - Street 1:235 HUMPHREY ROAD
Practice Address - Street 2:TWO PINEVIEW PLACE, SUITE 4
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-832-7880
Practice Address - Fax:724-832-8172
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004040L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015131090007Medicaid
PA480027303OtherRAILROAD SOMERSET
PA480026977OtherRAILROAD GREENSBURG
PA1035587OtherGATEWAY
PA14897718OtherUNITED MINE WORKERS
PA2072586OtherAETNA USHC
PA64700OtherMEDPLUS THREE RIVERS
PA178186OtherBLUE SHIELD
PA50675OtherHEALTH AMERICA
PA0015131090005Medicaid
PA4171401OtherCIGNA HEALTHCARE
PA480026977OtherRAILROAD MT PLEASANT
PA14897718OtherUNITED MINE WORKERS
PA178176MVAMedicare PIN