Medical Practices Of Antietam LLC
General Practice in Hagerstown, MD. Organization (NPI-2).
NPI number1134074396
StatusActive
Last updated in NPPESMar 3, 2026
Details
- NPI
- 1134074396
- Entity type
- Organization (NPI-2)
- Legal business name
- Medical Practices Of Antietam LLC
- Organization subpart
- No
- Enumeration date
- Mar 3, 2026
- Certification date
- Mar 3, 2026
- Last updated
- Mar 3, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
1130 Professional CtHagerstown, MD 21740-5852
Phone 240-313-9650
Mailing address
11116 Medical Campus RdHagerstown, MD 21742-6710
Authorized official
Joshua Repac
Cfo
3017909351
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All 16 General Practice Physician providers in Hagerstown · All 3,431 providers in Hagerstown
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