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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ANDREW JACKSON ETHERIDGE IV, CCA, CFO, CFM, CPED

Active

229N00000X · BALTIMORE, MD

Registration Details

NPI Number
1487246369
Provider Type
Individual
Gender
Male
NPI Issued
Feb 11, 2021 (5.1927100023165 yrs)
Last Updated
Aug 30, 2022

Practice Information

Address
601 N CAROLINE ST FL 6
BALTIMORE, MD, 212870006
Browse MD providers · Browse ZIP 21287
Phone
4109558215
Fax
4109551085
Primary Specialty
229N00000X
229N00000X
Additional Specialty
224900000X
Additional Specialty
224L00000X
Additional Specialty
Physical Therapist
Additional Specialty
229N00000X

Other 229N00000X Providers in BALTIMORE, MD

Name Credential NPI
MR. JUAN R GARCIA JR. CCA 1003840166
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.