{
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"FirstLineMailingAddress": "1400 FOREST GLEN RD",
"SecondLineMailingAddress": "SUITE 300",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-905-3500",
"MailingAddressFaxNumber": "301-905-3502",
"FirstLinePracticeLocationAddress": "2101 E JEFFERSON ST",
"SecondLinePracticeLocationAddress": "KAISER PERMANENTE MEDICARE ENROLLMENT",
"PracticeLocationAddressCityName": "ROCKVILLE",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2009",
"LastUpdateDate": "02/04/2022",
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"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Cardiovascular Disease Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}