Graduated: 1996
NPI: 1558439802
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
6701 N CHARLES ST
BALTIMORE, MD 212046808
4438492000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
Source: CMS National Downloadable File, September 2026.