# LIFEBRIDGE COMMUNITY PHYSICIANS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeBridge Suburban Physicians group, Llc D/B/A Dr. Russell Schub
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477160984
- **Authorized official:** MARY REBECCA WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (410) 701-4439

## Contact information

- **Practice address:** 8875 CENTRE PARK DR STE D, COLUMBIA, MD 21045-2382
- **Practice address phone:** (410) 489-3020
- **Mailing address:** 8875 CENTRE PARK DR STE D, COLUMBIA, MD 21045-2382

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/29/2020
- **Last updated:** 09/29/2020