Provider Demographics
NPI:1255679460
Name:ARTIS, ASHLEY J
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:ARTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:013-340-9027
Practice Address - Street 1:10801 LOCKWOOD DR
Practice Address - Street 2:SUITE 320
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-681-3400
Practice Address - Fax:301-681-7982
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD80218207V00000X
MDD0080218207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD100211200Medicaid
MD100211200Medicaid
MD444712ZAEMedicare PIN