Graduated: 1986
NPI: 1265500516
Practice Locations (4)
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
5100 AUTH WAY
SUITLAND, MD 207464207
3017025000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
2391 GREENSPRING DR
TIMONIUM, MD 210936038
3018162424
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
13285 MINNIEVILLE RD
WOODBRIDGE, VA 221924018
7039862400
Source: CMS National Downloadable File, September 2026.