# LIFEBRIDGE COMMUNITY PHYSICIANS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeBridge Endocrinology Assocaites
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477102309
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 422-9941

## Contact information

- **Practice address:** 5450 KNOLL NORTH DR STE 100, COLUMBIA, MD 21045-2366
- **Practice address phone:** (410) 368-1370
- **Mailing address:** 5450 KNOLL NORTH DR STE 100, COLUMBIA, MD 21045-2366
- **Mailing address phone:** (410) 601-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2019
- **Last updated:** 11/09/2021