# LIFEBRIDGE COMMUNITY PHYSICIANS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifebridge Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346513538
- **Authorized official:** MR. MARY R WRIGHT-SISK (VICE PRESIDENT)
- **Authorized official phone:** (443) 422-9941

## Contact information

- **Practice address:** 1401 PULASKI HWY, SUITE M, EDGEWOOD, MD 21040-1398
- **Practice address phone:** (410) 671-9241
- **Practice address fax:** (410) 671-9242
- **Mailing address:** 1401 PULASKI HWY, SUITE M, EDGEWOOD, MD 21040-1398
- **Mailing address phone:** (410) 671-9241
- **Mailing address fax:** (410) 671-9242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0068088 | MD | Yes |

## Other

- **Enumeration date:** 02/17/2012
- **Last updated:** 08/27/2021