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Andrew Jackson Etheridge IV, CCA,CFO,CFM,CPED
Anaplastologist in Baltimore, Maryland
NPI 1487246369

Andrew Jackson Etheridge IV is an Anaplastologist based in Baltimore, MD. Andrew Jackson Etheridge IV practices in Baltimore, MD and has the professional credentials of CCA,CFO,CFM,CPED. The NPI Number for Andrew Jackson Etheridge IV is 1487246369 and holds a License No. (Maryland).

The current practice location address for Andrew Jackson Etheridge IV is 601 N Caroline St Fl 6, Baltimore, MD and can be reached out via phone at 410-955-8215 and via fax at 410-955-1085.

Location: 601 N Caroline St Fl 6, Baltimore, MD, 21220-2004
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487246369
Provider Name
Andrew Jackson Etheridge IV
Credential
CCA,CFO,CFM,CPED
Provider Entity Type
Individual
Gender
Male
Address
601 N Caroline St Fl 6, Baltimore, MD, 21220-2004
Phone Number
410-955-8215
Fax Number
410-955-1085
Provider Enumeration Date
02/11/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
601 N Caroline St Fl 6
City
Baltimore
State
Maryland
Zip
21287-0006
Phone Number
410-955-8215
Fax Number
410-955-1085
person
Provider Business Mailing Address Details
Address
601 N Caroline St Fl 6
City
Baltimore
State
Maryland
Zip
21287-0006
Phone Number
410-955-8215
Fax Number
410-955-1085
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Ocularist
Taxonomy
156FX1700X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Mastectomy Fitter
Speciality
-
Taxonomy
224900000X
License No.
()
Definition
An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
person
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
()
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
person
Provider's Taxonomy Details 4
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotic Fitter
Speciality
-
Taxonomy
225000000X
License No.
()
Definition
An individual trained in the management of fitting prefabricated orthoses.
person
Provider's Taxonomy Details 5
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Anaplastologist
Speciality
-
Taxonomy
229N00000X
License No.
()
Definition
An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA).
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