# LIFEBRIDGE COMMUNITY PHYSICIANS INC

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

## Provider details

- **NPI number:** 1407656192
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 422-9941

## Contact information

- **Practice address:** 8871 GORMAN RD, LAUREL, MD 20723-5877
- **Practice address phone:** (301) 498-3150
- **Practice address fax:** (410) 601-8886
- **Mailing address:** 8871 GORMAN RD, LAUREL, MD 20723-5877
- **Mailing address phone:** (301) 498-3150
- **Mailing address fax:** (410) 601-8886

## Taxonomy

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

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 03/13/2025