MEDICARE: ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC

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	2084P0800X	Psychiatry Physician
2	282N00000X	General Acute Care Hospital	16003	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932146461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	11711 LIVINGSTON RD
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-5151
Country	:	US
Telephone Number	:	301-203-2599
Fax Number	:	301-203-7892

Provider Business Practice Location Address
First Line	:	11711 LIVINGSTON RD
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-5151
Country	:	US
Telephone Number	:	301-203-2599
Fax Number	:	301-203-7892

Authorized Official
Title or Position	:	SVP/CFO
Name	:	KRISTEN PULIO
Credential	:
Telephone Number	:	301-315-3569

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/10/2024

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