Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Other names
Penderbrook Medical Center Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COLLEEN E SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2797
Entity
Organization
Contact information
Practice address
12011 LEE JACKSON HIGHWAY, FAIRFAX, VA 22033-3310
(703) 257-3050
(703) 257-3042
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 816-2424
(301) 816-7170
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
12/05/2006
Last updated
07/24/2025
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