Provider Demographics
NPI:1952311482
Name:GEORGE, ASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-0424
Mailing Address - Country:US
Mailing Address - Phone:410-414-3437
Mailing Address - Fax:410-414-3451
Practice Address - Street 1:230 W DARES BEACH RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3150
Practice Address - Country:US
Practice Address - Phone:410-414-3437
Practice Address - Fax:410-414-3451
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD59442207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD395A-PAOtherCAREFIRST MD
MDJ527OtherCAREFIRST BLUECHOICE & F
MD2121894OtherFELRA & GEHA
MD408633300Medicaid
MD7253531OtherAETNA
MDH89112Medicare UPIN
MD7253531OtherAETNA