Healthcare Provider Details

I. General information

NPI: 1669000725
Provider Name (Legal Business Name): ASHLEY GATHERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9692 PENNSYLVANIA AVE
UPPER MARLBORO MD
20772-3670
US

IV. Provider business mailing address

12211 PLUM ORCHARD DR STE 220
SILVER SPRING MD
20904-7919
US

V. Phone/Fax

Practice location:
  • Phone: 301-599-7300
  • Fax: 301-599-0476
Mailing address:
  • Phone: 301-754-3060
  • Fax: 301-681-0789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD97837
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: