Provider Demographics
NPI:1013131739
Name:ASHTON, EDWARD B (DC, PT)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:B
Last Name:ASHTON
Suffix:
Gender:M
Credentials:DC, PT
Other - Prefix:
Other - First Name:E
Other - Middle Name:BRIAN
Other - Last Name:ASHTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, PT
Mailing Address - Street 1:962 WAYNE AVE
Mailing Address - Street 2:STE. L-A
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4433
Mailing Address - Country:US
Mailing Address - Phone:301-587-9717
Mailing Address - Fax:301-587-9714
Practice Address - Street 1:962 WAYNE AVE
Practice Address - Street 2:STE. L-A
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4433
Practice Address - Country:US
Practice Address - Phone:301-587-9717
Practice Address - Fax:301-587-9714
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16233225100000X
MD01669111N00000X, 111NR0400X, 111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6456844001OtherCIGNA
DC4624-0001OtherCAREFIRST BLUECROSS
MD53475902OtherBLUECROSSBLUESHIELD
MD4624-0001OtherCAREFIRST BLUECROSS BLUES
MDU57331Medicare UPIN
MD53475902OtherBLUECROSSBLUESHIELD