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

Medical Practices of Antietam LLC

Organization Family Medicine Physician · NPI 1619790953

Medical Practices of Antietam LLC is a Family Medicine Physician in Hagerstown, Maryland. Registered with an NPI since 2024.

In the registry since
2024
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 200
Hagerstown, MD 21742-6797
Phone: (301) 714-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1619790953
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedNovember 5, 2024
Last updated in NPPESNovember 5, 2024
Certification dateNovember 5, 2024
Mailing address11110 Medical Campus Rd Ste 200, Hagerstown, MD 21742-6797

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