Healthcare Provider Details

I. General information

NPI: 1659283224
Provider Name (Legal Business Name): ADVENTIST PHYSICIAN SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6430 ROCKLEDGE DR STE 110
BETHESDA MD
20817-1856
US

IV. Provider business mailing address

820 W DIAMOND AVE STE 500
GAITHERSBURG MD
20878-1469
US

V. Phone/Fax

Practice location:
  • Phone: 240-630-8241
  • Fax:
Mailing address:
  • Phone: 301-315-3102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: OKEZUE NWACHUKU
Title or Position: MANAGED CARE DIRECTOR
Credential:
Phone: 301-315-3030