MEDICAL PRACTICES OF ANTIETAM LLC NPI 1518686229

NPI Information

NPI: 1518686229
Provider Name: MEDICAL PRACTICES OF ANTIETAM, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 21D2281566

Address:
11110 MEDICAL CAMPUS RD STE 241
HAGERSTOWN, MD
ZIP 21742
Phone: (301) 714-4460
Get Directions

MEDICAL PRACTICES OF ANTIETAM, LLC is an ambulatory surgical clinic center in Hagerstown, MD. MEDICAL PRACTICES OF ANTIETAM, LLC NPI is 1518686229. The provider is registered as an organization entity type.

The provider's business location address is:

11110 MEDICAL CAMPUS RD STE 241
HAGERSTOWN, MD
ZIP 21742-756
Phone: (301) 714-4460

The provider's authorized official is Joshua Repac .
The authorized official title is Cfo and has the following contact phone number (301) 790-9351.

The CLIA number assigned to this NPI record is 21D2281566 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/25/2022 and was last updated on 8/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	305S00000X	Point of Service				No
2	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »