Provider Demographics
NPI:1710972781
Name:ASHBECK, GARTH A (MD)
Entity Type:Individual
Prefix:DR
First Name:GARTH
Middle Name:A
Last Name:ASHBECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1111 BENFIELD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-3002
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:443-679-1382
Practice Address - Street 1:24 MAGOTHY BEACH RD STE A
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4414
Practice Address - Country:US
Practice Address - Phone:410-255-2700
Practice Address - Fax:410-437-1962
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8138058OtherMAMSI PRIMARY CARE
MDP00381801OtherRR MEDICARE
MDP16894OtherCAREFIRST MPOS
MD1107284OtherAETNA CAPITATED
MD2138058OtherMAMSI SPECIALIST
MD621212-05OtherCAREFIRST MD RENDERING
MD7605-0077OtherCAREFIRST BLUECHOICE
MD403279900Medicaid
MD5848584OtherCIGNA PIN
MD125507OtherJHHC PROVIDER NUMBER
MD7396517OtherAETNA FEE FOR SERVICE
MDG43634Medicare UPIN
226LM587Medicare PIN