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

Medical Practices of Antietam LLC

Organization Pulmonary Disease Physician · NPI 1093513632

Medical Practices of Antietam LLC is a Pulmonary Disease Physician in Frederick, Maryland. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
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

604 Solarex Ct Unit 207
Frederick, MD 21703-8655
Phone: (240) 439-4344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1093513632
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedMarch 7, 2025
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address11116 Medical Campus Rd, Hagerstown, MD 21742-6710

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