Organization
MEDICAL PRACTICES OF ANTIETAM LLC
Active
Parent organization
MEDICAL PRACTICES OF ANTIETAM LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL PRACTICES OF ANTIETAM LLC
Authorized official
JOSHUA REPAC (CFO)
(301) 790-9351
Entity
Organization
Contact information
Practice address
1300 MARSHALL ST, HAGERSTOWN, MD 21740-3509
(301) 766-8403
Mailing address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
(301) 790-8000
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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