Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

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

Individual provider Ocularist · NPI 1487246369

Andrew Jackson Etheridge IV, CCA, CFO, CFM, CPED is an Ocularist in Baltimore, Maryland. Works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5

Practice location Address checks out

601 N Caroline St Fl 6
Baltimore, MD 21287-0006
Phone: (410) 955-8215
Fax: (410) 955-1085
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2613 Carver St, Durham, NC 27705-2720 — (919) 383-1205

Specialties & licences

Anaplastologist (primary) Taxonomy 229N00000X
Ocularist Taxonomy 156FX1700X
Mastectomy Fitter Taxonomy 224900000X
Pedorthist Taxonomy 224L00000X
Orthotic Fitter Taxonomy 225000000X

Record details

NPI number1487246369
Entity typeIndividual (Type 1)
GenderMale
Credentials CCA , CFO , CFM , CPED
Sole proprietorNo
NPI enumeratedFebruary 11, 2021
Last updated in NPPESAugust 30, 2022
Certification dateAugust 30, 2022

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