Andrew Jackson Etheridge IV, CCA, CFO, CFM, CPED

NPI #1487246369 in Baltimore, Maryland

Provider Information

NPI Number: 1487246369
Entity Type: Individual
Name: Andrew Jackson Etheridge IV, CCA, CFO, CFM, CPED
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Anaplastologist
Credential: CCA, CFO, CFM, CPED
Enumeration Date: Feb 11, 2021
Last Updated: Aug 30, 2022

Practice Location

Address: 601 N CAROLINE ST FL 6
City: Baltimore
State: Maryland
ZIP Code: 21287-0006
Phone: (410) 955-8215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Ocularist — Ocularist	156FX1700X
Mastectomy Fitter	224900000X
Pedorthist	224L00000X
Orthotic Fitter	225000000X
Anaplastologist	229N00000X	Primary

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Organizations

Provider Name	Specialty	City
Johns Hopkins University Part of Johns Hopkins University	Anaplastologist	Baltimore	AI Deep Dive
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