Graduated: 1996
NPI: 1497162093
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
700 2ND ST NE
WASHINGTON, DC 200028100
2023463000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
13285 MINNIEVILLE RD
WOODBRIDGE, VA 221924018
7039862400
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
14139 POTOMAC MILLS RD
WOODBRIDGE, VA 221924644
7032573000
Source: CMS National Downloadable File, September 2026.