Graduated: 2010
NPI: 1356734917
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
12255 FAIR LAKES PKWY
FAIRFAX, VA 220333952
7032374800
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
10701 ROSEMARY DR
MANASSAS, VA 201097282
7032573000
Source: CMS National Downloadable File, September 2026.