| Medical Practices Of Antietam Llc | |
|
4991 New Design Rd Ste 103 Frederick MD 21703-7342 | |
| (301) 790-8000 | |
| Not Available |
| Full Name | Medical Practices Of Antietam Llc |
|---|---|
| Speciality | Surgery |
| Location | 4991 New Design Rd Ste 103, Frederick, 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 |
|---|---|
| Medical Practices Of Antietam Llc 11116 Medical Campus Rd Hagerstown MD 21742-6710 Ph: () - | Medical Practices Of Antietam Llc 4991 New Design Rd Ste 103 Frederick MD 21703-7342 Ph: (301) 790-8000 |
| NPI Number | 1477351013 |
|---|---|
| Provider Enumeration Date | 03/07/2025 |
| Last Update Date | 03/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477351013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Primary |
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