# LIFEBRIDGE COMMUNITY PHYSICIANS, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFEBRIDGE COMMUNITY PHYSICIANS, INC
- **Other names:** Carroll Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1548516529
- **Legal business name:** LIFEBRIDGE COMMUNITY PHYSICIANS, INC
- **Authorized official:** MARY R WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (443) 422-9941

## Contact information

- **Practice address:** 4231 N WOODS TRL, HAMPSTEAD, MD 21074-3128
- **Practice address phone:** (410) 374-9391
- **Practice address fax:** (410) 374-1866
- **Mailing address:** 4231 N WOODS TRL, HAMPSTEAD, MD 21074-3128
- **Mailing address phone:** (410) 374-9391
- **Mailing address fax:** (410) 374-1866

## Taxonomy

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

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 08/27/2021