Graduated: 1989
NPI: 1255331252
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
655 WATKINS MILL RD
GAITHERSBURG, MD 208793301
2406324000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
Source: CMS National Downloadable File, September 2026.