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 ROAD, SUITE 229, HAGERSTOWN, MD 21742
(301) 665-4531
(301) 790-9103
Mailing address
11110 MEDICAL CAMPUS ROAD, SUITE 229, HAGERSTOWN, MD 21742
(301) 665-4531
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/08/2006
Last updated
10/26/2022
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