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Medical Practices Of Antietam LLC

Orthopaedic Surgery in Hagerstown, MD. Organization (NPI-2).

NPI number1831997477
StatusActive
Last updated in NPPESMar 7, 2025

Details

NPI
1831997477
Entity type
Organization (NPI-2)
Legal business name
Medical Practices Of Antietam LLC
Organization subpart
No
Enumeration date
Mar 7, 2025
Certification date
Mar 7, 2025
Last updated
Mar 7, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery––Yes
208D00000X General Practice––

Practice location

11110 Medical Campus Rd Ste 205
Hagerstown, MD 21742-6797

Phone 301-665-4950

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Authorized official

Joshua Repac
Cfo
3017909351

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