Graduated: 2004
NPI: 1417061235
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
7141 SECURITY BLVD, WOODLAWN MED CTR
BALTIMORE, MD 212441811
4436636000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
7070 SAMUEL MORSE DR
COLUMBIA, MD 210463424
4103094600
Source: CMS National Downloadable File, September 2026.