Healthcare Provider Details
I. General information
NPI: 1700612074
Provider Name (Legal Business Name): ADVENTIST PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11886 HEALING WAY STE 404
SILVER SPRING MD
20904-7917
US
IV. Provider business mailing address
820 W DIAMOND AVE STE 500
GAITHERSBURG MD
20878-1469
US
V. Phone/Fax
- Phone: 240-637-6000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRAN
LINFORD
Title or Position: ANALYST
Credential:
Phone: 301-315-3826