Organization
LIFEBRIDGE SUBURBAN PHYSICIAN GROUP II LLC
Active
Other names
Dr. Gaurav Kumar at Madison Park
Organization subpart
No
Provider details
NPI number
Authorized official
MARY REBECCA WRIGHT-SISK (DIRECTOR)
(443) 422-9941
Entity
Organization
Contact information
Practice address
1405 MADISON PARK DR, GLEN BURNIE, MD 21061-5627
(410) 308-7865
(410) 308-7818
Mailing address
1405 MADISON PARK DR, GLEN BURNIE, MD 21061-5627
(410) 308-7865
(410) 308-7818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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