MEDICARE: DR. PROMISE A. AHLSTROM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D0037733	MD
2	208000000X	Pediatrics Physician	MD17595	DC

General Provider Information

NPI Number	:	1427074004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PROMISE A. AHLSTROM M.D.

Provider Business Mailing Address
First Line	:	6931 ARLINGTON RD STE 340
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-5231
Country	:	US
Telephone Number	:	202-363-0300
Fax Number	:	202-363-7251

Provider Business Practice Location Address
First Line	:	6931 ARLINGTON RD STE 340
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-5231
Country	:	US
Telephone Number	:	202-363-0300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	09/15/2025

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