Graduated: 2012
NPI: 1013265321
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
4400 FORBES BLVD
LANHAM, MD 207064447
3013413882
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
Source: CMS National Downloadable File, September 2026.