Medical school: EDWARD VIA COL OF OSTEO MEDICINE-CAROLINAS CAMPUS
Graduated: 2020
NPI: 1588291405
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
5100 AUTH WAY
SUITLAND, MD 207464207
3017025000
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
6104 OLD BRANCH AVE
TEMPLE HILLS, MD 207482518
3017026100
Source: CMS National Downloadable File, September 2026.