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Organization
MEDICAL PRACTICES OF ANTIETAM LLC
Active
Organization
MEDICAL PRACTICES OF ANTIETAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA REPAC (CFO)
(301) 790-9351
Entity
Organization
Contact information
Practice address
49 ST PAUL DR, CHAMBERSBURG, PA 17201-1020
(717) 261-1620
Mailing address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
208200000X
Plastic Surgery Physician
—
NULL
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/07/2025
Last updated
05/05/2026
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