Graduated: 2020
NPI: 1437747805
Practice Locations (2)
MDICS AT CIVISTA LLC
5 GARRETT AVE
LA PLATA, MD 206465960
4439490814
MDICS AT CALVERT LLC
100 HOSPITAL RD
PRINCE FREDERICK, MD 206784016
4105354000
Source: CMS National Downloadable File, September 2026.