Medical school: ST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Graduated: 1988
NPI: 1174511919
Practice Locations (2)
MARY WASHINGTON HEALTHCARE PROVIDERS LLC
3914 W SAN PEDRO ST
TAMPA, FL 336297810
5407415610
MARY WASHINGTON HEALTHCARE PROVIDERS LLC
101 HOSPITAL CTR BLVD
STAFFORD, VA 225546200
5407414350
Source: CMS National Downloadable File, September 2026.