Provider Demographics
NPI:1841297090
Name:BOBB, DAVID W (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:BOBB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 MACDONALD RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5885
Mailing Address - Country:US
Mailing Address - Phone:571-285-3930
Mailing Address - Fax:
Practice Address - Street 1:5302 MACDONALD RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5885
Practice Address - Country:US
Practice Address - Phone:571-285-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2016-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-12113183500000X
VA0202214515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist