Healthcare Provider Details

I. General information

NPI: 1407778210
Provider Name (Legal Business Name): ADVENTIST PHYSICIAN SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19735 GERMANTOWN RD STE 310
GERMANTOWN MD
20874-1231
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 301-972-6444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: OKEZUE NWACHUKU
Title or Position: MANAGED CARE DIRECTOR
Credential:
Phone: 301-315-3170