Organization
LIFEBRIDGE SUBURBAN PHYSICIAN GROUP II, LLC
Active
Parent organization
LIFEBRIDGE COMMUNITY PHYSICIANS, INC.
Other names
Dr. Gaurav Kumar
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC.
Authorized official
MARY R WRIGHT-SISK (DIRECTOR)
(443) 422-9941
Entity
Organization
Contact information
Practice address
12221 TULLAMORE RD, LUTHERVILLE, MD 21093-7816
(410) 252-6790
Mailing address
12221 TULLAMORE RD, LUTHERVILLE, MD 21093-7816
(410) 252-6790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/06/2016
Last updated
08/31/2021
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