Organization
MEDICAL PRACTICES OF ANTIETAM, LLC
Active
Other names
Meritus Cosmetic and Plastic Surgery Center
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 241, HAGERSTOWN, MD 21742-6756
(301) 714-4460
Mailing address
11110 MEDICAL CAMPUS RD STE 241, HAGERSTOWN, MD 21742-6756
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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