Graduated: 1994
NPI: 1386912285
Practice Locations (2)
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
12201 PLUM ORCHARD DR
SILVER SPRING, MD 209047803
3015721000
Source: CMS National Downloadable File, September 2026.