# LIFEBRIDGE COMMUNITY PHYSICIANS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeBridge Health Medical Group Primary Care of Randallstown
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447983325
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 623-8926

## Contact information

- **Practice address:** 8600 LIBERTY RD FL 2, RANDALLSTOWN, MD 21133-4767
- **Practice address phone:** (410) 521-4211
- **Practice address fax:** (410) 521-0627
- **Mailing address:** 8600 LIBERTY RD FL 2, RANDALLSTOWN, MD 21133-4767
- **Mailing address phone:** (410) 521-4211
- **Mailing address fax:** (410) 521-0627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2022
- **Last updated:** 07/07/2022