Healthcare Provider Details

I. General information

NPI: 1891666541
Provider Name (Legal Business Name): ADVENTIST PHYSICIAN SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14915 BROSCHART RD
ROCKVILLE MD
20850-3350
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 301-828-4912
  • Fax:
Mailing address:
  • Phone: 301-315-3102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TAWANDA MCPHERSON
Title or Position: PROVIDER ENROLLMENT ANALYST
Credential:
Phone: 202-560-8469