Graduated: 2006
NPI: 1104927748
Practice Locations (2)
MDICS AT CIVISTA LLC
5 GARRETT AVE
LA PLATA, MD 206465960
4439490814
KIDNEY MEDICAL ASSOCIATES INC
4475 REGENCY PL, SUITE 201
WHITE PLAINS, MD 206953074
3016387802
Source: CMS National Downloadable File, September 2026.