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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
1130 PROFESSIONAL CT, HAGERSTOWN, MD 21740-5852
(240) 313-9650
Mailing address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
03/03/2026
Last updated
03/03/2026
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