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Organization
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Active
Organization
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Active
Other names
Main Street Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WRIGHT-SISK (DIRECTOR)
(443) 422-9941
Entity
Organization
Contact information
Practice address
515 FAIRMOUNT AVE, SUITE 200, TOWSON, MD 21286-5466
(410) 494-1369
(410) 494-2737
Mailing address
515 FAIRMOUNT AVE, SUITE 200, TOWSON, MD 21286-5466
(410) 494-1369
(410) 494-2737
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
MD
Other
Enumeration date
06/06/2013
Last updated
08/27/2021
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