NPI 1053829796 · live from the CMS NPI Registry
Cody Eccard, PA-C
Physician Assistant in Fulton, MD. National Provider Identifier 1053829796, active.
NPI record
| NPI | 1053829796 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 8115 Maple Lawn Blvd Ste 350, Fulton, MD 20759 |
| Practice phone | 551-295-8223 |
| Mailing address | 14611 Water Company Rd, Cascade, MD 21719 |
| Enumerated | January 16, 2018 |
| Last updated | December 23, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | C0006734 (MD) |
| Physician Assistant primary | 363A00000X | 0110-006896 (VA) |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | 0110-006896 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.