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General NPI Number Information
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NPI Number | 1780973305
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Entity Type | Individual
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Provider Name | NELSON C ECHEBIRI M.D, MBA
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Gender | Male
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 26005 RIDGE RD STE 200
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City | DAMASCUS
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State | MD
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Zip | 20872-1899
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Country | US
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Telephone | 301-414-2300
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Fax | 301-414-2306
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Provider Business Mailing Address
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Address Line | PO BOX 1100
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City | WHITE PLAINS
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State | MD
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Zip | 20695-1100
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Country | US
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Telephone | 240-252-2140
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Fax | 240-252-2141
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101258139
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 28572
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D80259
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License Number State | MD
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