Lifebridge Suburban Physician Group II LLC
NPI #1194170027 in Randallstown, Maryland
Provider Information
- NPI Number
- 1194170027
- Entity Type
- Organization
- Organization Name
- Lifebridge Suburban Physician Group II LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LIFEBRIDGE COMMUNITY PHYSICIANS, INC.
- Primary Specialty
- Pediatrics - Adolescent Medicine
- Enumeration Date
- Apr 28, 2016
- Last Updated
- Aug 31, 2021
Practice Location
- Address
- 5400 OLD COURT RD STE 300B
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133-5100
- Phone
- (410) 521-7337
Authorized Official
- Name
- MARY WRIGHT-SISK
- Title
- DIRECTOR
- Phone
- (443) 422-9941
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Adolescent Medicine — Adolescent Medicine |
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