Lifebridge Suburban Physician Group II LLC

NPI #1104617422 in Baltimore, Maryland

Provider Information

NPI Number: 1104617422
Entity Type: Organization
Organization Name: Lifebridge Suburban Physician Group II LLC
Primary Specialty: Pediatrics
Enumeration Date: May 15, 2025
Last Updated: May 15, 2025

Practice Location

Address: 6701 N CHARLES ST
City: Baltimore
State: Maryland
ZIP Code: 21204-6808
Phone: (410) 308-7865

Authorized Official

Name: MARY REBECCA WRIGHT-SISK
Title: DIRECTOR
Phone: (443) 422-9941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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