Graduated: 1995
NPI: 1538232855
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
7670 QUARTERFIELD RD
GLEN BURNIE, MD 210613947
4105087650
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
Source: CMS National Downloadable File, September 2026.