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

Medical Practices of Antietam LLC

Organization Gynecology Physician · NPI 1710700042

Medical Practices of Antietam LLC is a Gynecology 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 147
Hagerstown, MD 21742-6755
Phone: (301) 791-5555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gynecology Physician (primary) Taxonomy 207VG0400X

Record details

NPI number1710700042
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedNovember 5, 2024
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026
Mailing address1130 Professional Ct, Hagerstown, MD 21740-5852

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