Ancillary Provider Interest Form

Vendors Interested in participating with MedStar Select

If you are an ancillary provider and interested in participating with MedStar Select, please complete the 
New Vendor Interest Form and mail or fax it to MedStar Select. Our contracting department will contact with 
you to discuss your interest in MedStar Select.

 

Complete this form and send to:

MedStar Family Choice
ATTN: Contracting Department
5233 King Avenue, Ste 400
Baltimore, MD 21237

Phone: 410-933-3074
Fax: 410-933-3077