Organization
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Active
Other names
LifeBridge Surgical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARY R WRIGHT-SISK (DIRECTOR)
(443) 422-9941
Entity
Organization
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H68214
MD
Other
Enumeration date
10/14/2015
Last updated
08/27/2021
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