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
11110 MEDICAL CAMPUS RD STE 107, HAGERSTOWN, MD 21742-6734
(301) 714-4100
Mailing address
11110 MEDICAL CAMPUS RD STE 107, HAGERSTOWN, MD 21742-6734
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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