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
351 N PENNSYLVANIA AVE, HANCOCK, MD 21750-1046
(301) 678-2901
Mailing address
351 N PENNSYLVANIA AVE, HANCOCK, MD 21750-1046
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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