MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1346315280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Provider Business Mailing Address
First Line	:	4000 GARDEN CITY DR
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-2418
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	4920 CAMPBELL BOULEVARD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21236-5916
Country	:	US
Telephone Number	:	410-933-7632
Fax Number	:	410-933-7668

Authorized Official
Title or Position	:	DIRECTOR, CREDENTIALING
Name	:	COLLEEN SWINTON
Credential	:
Telephone Number	:	301-257-2797

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/24/2025

Similar Medicare Providers

1407960032 — STEVEN ALLEN BLACKWELL PH.D., J.D., R.PH.
Practice Location Address:

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax:

1396961561 — DR. MARSHA SMITH MD
Practice Location Address:

7500 SECURITY BOULEVARD , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21201-2301

Practice Phone: 410-786-6614
Practice Fax:

1134335441 — JULIE DAWN PREIS
Practice Location Address:

7500 SECURITY BLVD MS C1-13-07 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244

Practice Phone: 410-786-0525
Practice Fax:

1851459804 — DR. SUSAN WILLARD MD
Practice Location Address:

4920 CAMPBELL BOULEVARD
BALTIMORE, MD
21236-5916

Practice Phone: 410-933-7600
Practice Fax: 410-933-7601

1700944071 — DR. PAUL ANTHONY ZILIOLI MD
Practice Location Address:

4920 CAMPBELL BLVD
BALTIMORE, MD
21236-5916

Practice Phone: 410-933-7638
Practice Fax: 410-933-7802

1184788234 — MS. ALICE ANN ALDRICH PAC
Practice Location Address:

4920 CAMPBELL BOULEVARD
BALTIMORE, MD
21236-5916

Practice Phone: 410-933-7600
Practice Fax: 410-933-7601

Directions to “KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.