New Provider Interest Form

New Providers interested in participating with MedStar Select

If you are a new provider interested in participating with MedStar Select, please complete the New Provider Interest Form and mail or fax it to MedStar Select. Our provider relations department will contact with you to discuss your interest in MedStar Select.

Complete this form and send to:

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

Phone: 410-933-2200 Opt. 5
Fax: 410-933-3077