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Organization

LIFEBRIDGE COMMUNITY PHYSICIANS INC

Active
Other names
LifeBridge Suburban Physicians group, Llc D/B/A Dr. Russell Schub
Organization subpart
No

Provider details

NPI number
Authorized official
MARY REBECCA WRIGHT-SISK (DIRECTOR)
(410) 701-4439
Entity
Organization

Contact information

Practice address
8875 CENTRE PARK DR STE D, COLUMBIA, MD 21045-2382
(410) 489-3020
Mailing address
8875 CENTRE PARK DR STE D, COLUMBIA, MD 21045-2382

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Enumeration date
09/29/2020
Last updated
09/29/2020
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