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Organization

LIFEBRIDGE COMMUNITY PHYSICIANS, INC

Active
Other names
Potomac Professionals
Organization subpart
No

Provider details

NPI number
Authorized official
MARY WRIGHT-SISK M.D. (DIRECTOR)
(443) 422-9941
Entity
Organization

Contact information

Practice address
5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5126
(410) 521-7337
(410) 521-7377
Mailing address
5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133-5126
(410) 521-7337
(410) 521-7377

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician

Other

Enumeration date
11/08/2013
Last updated
03/05/2026
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