Graduated: 2015
NPI: 1578025268
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
12255 FAIR LAKES PKWY
FAIRFAX, VA 220333952
7032374800
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
13285 MINNIEVILLE RD
WOODBRIDGE, VA 221924018
7039862400
Source: CMS National Downloadable File, September 2026.