# MEDICAL PRACTICES OF ANTIETAM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841098589
- **Authorized official:** JOSHUA REPAC (CFO)
- **Authorized official phone:** (301) 790-9351

## Contact information

- **Practice address:** 49 ST PAUL DR, CHAMBERSBURG, PA 17201-1020
- **Practice address phone:** (717) 261-1620
- **Mailing address:** 11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2025
- **Last updated:** 05/05/2026