Provider Demographics
NPI:1720379225
Name:BLACKLEDGE, ASHLEY SHERI (MD)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SHERI
Last Name:BLACKLEDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:SHERI
Other - Last Name:CRUMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9729 COUNTRY MEADOWS LN
Mailing Address - Street 2:APT 1B
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-6305
Mailing Address - Country:US
Mailing Address - Phone:301-873-1932
Mailing Address - Fax:
Practice Address - Street 1:960 FOREST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3470
Practice Address - Country:US
Practice Address - Phone:302-735-1888
Practice Address - Fax:302-735-1802
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0010651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine