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Individual

EDWIN THOMAS PULASKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10215 FERNWOOD RD, STE 50, BETHESDA, MD 20817
(301) 564-1053
Mailing address
3015 WILLIAMS DRIVE, STE 200, FAIRFAX, VA 22031-4623
(703) 641-9133
(703) 280-5098

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
9601446
NC
2085R0202X
Diagnostic Radiology Physician
9601446
NC
2085R0202X
Diagnostic Radiology Physician
Primary
D0015047
MD
2085R0204X
Vascular & Interventional Radiology Physician
9601446
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1115H
BCBS
05
2004964000
WV
01
28411
PARTNERS
01
300130864
RR MEDICARE
01
5612683
AETNA
05
7200099
VA
01
78270
MEDCOST
05
891115H
NC
05
Q01446
SC
Enumeration date
12/01/2005
Last updated
05/15/2008
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