NPI 1487246369
Andrew Jackson Etheridge, CCACFOCFMCPED
Practice location
- Address
- 601 N Caroline St Fl 6, Baltimore, MD 21287-0006
- Phone
- (410) 955-8215
- Fax
- (410) 955-1085
- Mailing address
- 6201 Greenleigh Ave, Baltimore, MD 21220-2004
Registered specialties (5)
Anaplastologist
Primary
Mastectomy Fitter
Pedorthist
Orthotic Fitter
Registry record
- NPI
- 1487246369
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 11 Feb 2021
- Record last updated
- 30 Aug 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.