Organization
LIFEBRIDGE COMMUNITY PHYSICIANS INC.
Active
Other names
LifeBridge Suburban Physician Group, LLC DBA Yaniv Berger, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY WRIGHT-SISK (DIRECTOR OF PHYSICIAN ENTERPRISE)
(443) 422-9941
Entity
Organization
Contact information
Practice address
2700 QUARRY LAKE DR, SUITE 280, BALTIMORE, MD 21209-3742
(410) 601-6897
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/28/2015
Last updated
08/27/2021
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