Medical Practices Of Antietam Llc | |
14303 Lake Royer Dr Cascade MD 21719-1602 | |
(240) 582-0694 | |
Not Available |
Full Name | Medical Practices Of Antietam Llc |
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Speciality | General Practice |
Location | 14303 Lake Royer Dr, Cascade, Maryland |
Authorized Official Name and Position | Joshua Repac (CFO) |
Authorized Official Contact | 3017909351 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Medical Practices Of Antietam Llc 11116 Medical Campus Rd Hagerstown MD 21742-6710 Ph: () - | Medical Practices Of Antietam Llc 14303 Lake Royer Dr Cascade MD 21719-1602 Ph: (240) 582-0694 |
NPI Number | 1750189494 |
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Provider Enumeration Date | 03/07/2025 |
Last Update Date | 03/07/2025 |
Identifier | Type | State | Issuer |
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1750189494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |