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

Medical Practices of Antietam LLC

Organization General Practice Physician · NPI 1134074396

Medical Practices of Antietam LLC is a General Practice Physician in Hagerstown, Maryland. Registered with an NPI since 2026.

In the registry since
2026
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

1130 Professional Ct
Hagerstown, MD 21740-5852
Phone: (240) 313-9650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1134074396
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedMarch 3, 2026
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026
Mailing address11116 Medical Campus Rd, Hagerstown, MD 21742-6710

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