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

Medical Practices of Antietam LLC

Organization Clinic/Center · NPI 1710854963

Medical Practices of Antietam LLC is a Clinic/Center in Hagerstown, Maryland. Registered with an NPI since 2025.

In the registry since
2025
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
Hagerstown, MD 21742-6700
Phone: (301) 790-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1710854963
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedOctober 22, 2025
Last updated in NPPESOctober 22, 2025
Certification dateOctober 22, 2025
Mailing address11110 Medical Campus Rd, Hagerstown, MD 21742-6700

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