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Organization

LIFEBRIDGE COMMUNITY PHYSICIANS, INC

Active
Other names
Lifebridge Health Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARY R WRIGHT-SISK (VICE PRESIDENT)
(443) 422-9941
Entity
Organization

Contact information

Practice address
1401 PULASKI HWY, SUITE M, EDGEWOOD, MD 21040-1398
(410) 671-9241
(410) 671-9242
Mailing address
1401 PULASKI HWY, SUITE M, EDGEWOOD, MD 21040-1398
(410) 671-9241
(410) 671-9242

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0068088
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
970084600
MD
Enumeration date
02/17/2012
Last updated
08/27/2021
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