# LIFEBRIDGE MULTI-SPECIALTY. LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699172387
- **Authorized official:** MARY WRIGHT-SISK (DIRECTOR)
- **Authorized official phone:** (410) 521-2200

## Contact information

- **Practice address:** 515 FAIRMOUNT AVE, TOWSON, MD 21286-5466
- **Practice address phone:** (410) 296-5300
- **Practice address fax:** (410) 494-1302
- **Mailing address:** 515 FAIRMOUNT AVE, TOWSON, MD 21286-5466
- **Mailing address phone:** (410) 296-5300
- **Mailing address fax:** (410) 494-1302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | MD | — |
| 207Q00000X | Family Medicine Physician | — | MD | — |
| 207R00000X | Internal Medicine Physician | — | MD | Yes |
| 207W00000X | Ophthalmology Physician | — | MD | — |
| 207Y00000X | Otolaryngology Physician | — | MD | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | MD | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | MD | — |
| 208600000X | Surgery Physician | — | MD | — |
| 208800000X | Urology Physician | — | MD | — |

## Other

- **Enumeration date:** 11/25/2014
- **Last updated:** 11/25/2014