Medical Practices of Antietam LLC
NPI #1710700042 in Hagerstown, Maryland
Provider Information
- NPI Number
- 1710700042
- Entity Type
- Organization
- Organization Name
- Medical Practices of Antietam LLC
- Primary Specialty
- Obstetrics & Gynecology - Gynecology
- Enumeration Date
- Nov 5, 2024
- Last Updated
- Nov 5, 2024
Practice Location
- Address
- 1130 PROFESSIONAL CT
- City
- Hagerstown
- State
- Maryland
- ZIP Code
- 21740-5852
- Phone
- (301) 791-5555
Authorized Official
- Name
- JOSHUA REPAC
- Title
- CFO
- Phone
- (301) 790-9351
Specialties & Taxonomy Codes
| Specialty |
|---|
| Obstetrics & Gynecology - Gynecology — Gynecology |
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