Healthcare Provider Details

I. General information

NPI: 1144247024
Provider Name (Legal Business Name): ADVENTIST PHYSICIAN SERVICES (WAH)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/02/2025
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9909 MEDICAL CENTER DR
ROCKVILLE MD
20850-6361
US

IV. Provider business mailing address

PO BOX 64742-02
BALTIMORE MD
21264-4742
US

V. Phone/Fax

Practice location:
  • Phone: 240-864-6007
  • Fax:
Mailing address:
  • Phone: 614-442-2400
  • Fax: 614-442-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN PULIO
Title or Position: SVP/CFO
Credential:
Phone: 301-315-3569