# LIFEBRIDGE COMMUNITY PHYSICIANS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeBridge Potomac Professionals at Crossroads
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053124768
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 623-8926

## Contact information

- **Practice address:** 23 CROSSROADS DR STE 340, OWINGS MILLS, MD 21117-5492
- **Practice address phone:** (410) 653-0366
- **Practice address fax:** (410) 601-4759
- **Mailing address:** 23 CROSSROADS DR STE 340, OWINGS MILLS, MD 21117-5492
- **Mailing address phone:** (410) 653-0366
- **Mailing address fax:** (410) 601-4759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/28/2025
- **Last updated:** 01/28/2025