Organization
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Active
Other names
LifeBridge Health Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MARY R WRIGHT-SISK MD (DIRECTOR)
(443) 422-9941
Entity
Organization
Contact information
Practice address
10084 REISTERSTOWN RD, SUITE 300A, OWINGS MILLS, MD 21117
(667) 219-6313
(443) 815-4706
Mailing address
10084 REISTERSTOWN RD, SUITE 300A, OWINGS MILLS, MD 21117
(667) 219-6313
(443) 815-4706
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0060491
MD
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
D0060491
MD
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
D0060491
MD
207XX0801X
Orthopaedic Trauma Physician
D0060491
MD
Other
Enumeration date
05/17/2018
Last updated
03/19/2025
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