Graduated: 1984
NPI: 1699833616
Practice Locations (2)
UNIVERSITY MEDICAL SERVICE ASSOCIATION INC
4202 E FOWLER AVE
TAMPA, FL 336206750
MEDICAL PRACTICES OF ANTIETAM, LLC
11110 MEDICAL CAMPUS RD, SUITE 107
HAGERSTOWN, MD 217426734
3017144100
Source: CMS National Downloadable File, September 2026.