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
11110 MEDICAL CAMPUS RD STE 229, HAGERSTOWN, MD 21742-6727
(301) 790-9072
Mailing address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
05/01/2026
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