Provider Demographics
NPI:1720326218
Name:ECHARD, BOBBY WILLIAM
Entity Type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:WILLIAM
Last Name:ECHARD
Suffix:
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 1:6639 WIND RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-7479
Mailing Address - Country:US
Mailing Address - Phone:301-829-4931
Mailing Address - Fax:
Practice Address - Street 1:6639 WIND RIDGE RD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-7479
Practice Address - Country:US
Practice Address - Phone:301-829-4931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD065332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies