Graduated: 2021
NPI: 1912643909
Practice Locations (2)
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
3000 POTOMAC AVE
ALEXANDRIA, VA 223053084
7037216300
Source: CMS National Downloadable File, September 2026.