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 1558430843

Medical Practices of Antietam, LLC is a General Practice Physician in Hagerstown, Maryland. Registered with an NPI since 2006.

In the registry since
2006
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

11110 Medical Campus Rd Ste 229
Hagerstown, MD 21742
Phone: (301) 665-4531
Fax: (301) 790-9103
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1558430843
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedNovember 8, 2006
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022
Mailing address11110 Medical Campus Road, Suite 229, Hagerstown, MD 21742

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