Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Organization Anatomic Pathology & Clinical Pathology Physician · NPI 1568520070

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc is an Anatomic Pathology & Clinical Pathology Physician in Fairfax, Virginia. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12011 Lee Jackson Hwy
Fairfax, VA 22033-3310
Phone: (703) 257-3050
Fax: (703) 257-3042
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X

Record details

NPI number1568520070
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Colleen Swinton — Credentialing Director · (301) 257-2797
Other names Penderbrook Medical Center Laboratory; Penderbrook Medical Center Laboratory
NPI enumeratedDecember 5, 2006
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025
Mailing address4000 Garden City Dr, Hyattsville, MD 20785-2418

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