# LIFEBRIDGE COMMUNITY PHYSICIANS, INC

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

## Provider details

- **NPI number:** 1588093652
- **Authorized official:** MARY WRIGHT-SISK M.D. (DIRECTOR)
- **Authorized official phone:** (443) 422-9941

## Contact information

- **Practice address:** 5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5126
- **Practice address phone:** (410) 521-7337
- **Practice address fax:** (410) 521-7377
- **Mailing address:** 5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5126
- **Mailing address phone:** (410) 521-7337
- **Mailing address fax:** (410) 521-7377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 11/08/2013
- **Last updated:** 03/05/2026