Graduated: 2004
NPI: 1003058538
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1201 HOSPITAL DR
FREDERICKSBURG, VA 224018428
5403683700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
8008 WESTPARK DR
MC LEAN, VA 221023109
7032876400
Source: CMS National Downloadable File, September 2026.