Medical school: NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1990
NPI: 1770645368
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
8008 WESTPARK DR
MC LEAN, VA 221023109
7032876400
Source: CMS National Downloadable File, September 2026.