Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifebridge Suburban Physician Group II LLC

Organization Pediatrics Physician · NPI 1033900352

Lifebridge Suburban Physician Group II LLC is a Pediatrics Physician in Glen Burnie, Maryland. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1405 Madison Park Dr
Glen Burnie, MD 21061-5627
Phone: (410) 308-7865
Fax: (410) 308-7818
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1033900352
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Wright-Sisk — Director · (443) 422-9941
Other names Dr. Gaurav Kumar At Madison Park
NPI enumeratedMay 15, 2025
Last updated in NPPESMay 15, 2025
Certification dateMay 15, 2025
Mailing address1405 Madison Park Dr, Glen Burnie, MD 21061-5627

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