NPI 1164220703

Medical Practices of Antietam LLC

Organisation Pain Medicine Physician Hagerstown, MD

Practice location

Address: 11110 Medical Campus Rd STE 225, Hagerstown, MD 21742-6727
Phone: (301) 665-4720
Mailing address: 11116 Medical Campus Rd, Hagerstown, MD 21742-6710

Authorised official

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

Registered specialties (2)

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X

Other Pain Medicine providers in Maryland →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Maryland →

Registry record

NPI: 1164220703
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.