Organization
LIFEBRIDGE MULTI-SPECIALTY. LLC
Active
Other names
Clinical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WRIGHT-SISK (DIRECTOR)
(410) 521-2200
Entity
Organization
Contact information
Practice address
515 FAIRMOUNT AVE, TOWSON, MD 21286-5466
(410) 296-5300
(410) 494-1302
Mailing address
515 FAIRMOUNT AVE, TOWSON, MD 21286-5466
(410) 296-5300
(410) 494-1302
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
MD
207Q00000X
Family Medicine Physician
—
MD
207R00000X
Internal Medicine Physician
Primary
—
MD
207W00000X
Ophthalmology Physician
—
MD
207Y00000X
Otolaryngology Physician
—
MD
207ZD0900X
Dermatopathology (Pathology) Physician
—
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
MD
208600000X
Surgery Physician
—
MD
208800000X
Urology Physician
—
MD
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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