1902901069 NPI number — WILLIAM R BOND JR MD LLC

Table of content: (NPI 1902901069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902901069 NPI number — WILLIAM R BOND JR MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM R BOND JR MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902901069
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13228 MOONLIGHT TRAIL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20906-6412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-871-8245
Provider Business Mailing Address Fax Number:
301-871-1246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 IRVING STREET N.W.
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-726-7770
Provider Business Practice Location Address Fax Number:
202-726-7702
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOND
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
RHODEN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
301-871-8245

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  D0025211 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011409900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7808216 04 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1902901069 . This is a "ORGANIZATION NPI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1730124041 . This is a "INDIVIDUAL NPI #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0K4HWR . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5309 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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