NPI 1114725850

Medical Practices of Antietam LLC

Organisation Plastic Surgery Physician Hagerstown, MD

Practice location

Address: 11110 Medical Campus Rd STE 241, Hagerstown, MD 21742-6756
Phone: (301) 714-4460
Mailing address: 11116 Medical Campus Rd, Hagerstown, MD 21742-6710

Authorised official

Name: Joshua Repac
Title: Cfo
Phone: (301) 790-9351

Registered specialties (3)

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X

Other Plastic Surgery providers in Maryland →

Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208600000X

Other Surgery providers in Maryland →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Maryland →

Registry record

NPI: 1114725850
Entity type: Organization
NPI issued: 7 Mar 2025
Record last updated: 7 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.