Healthcare Provider Details

I. General information

NPI: 1801780333
Provider Name (Legal Business Name): MARK TULIAO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1497
US

IV. Provider business mailing address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1497
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-3990
  • Fax:
Mailing address:
  • Phone: 301-896-3990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR166775
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: