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 1750189494

Medical Practices of Antietam LLC is a Family Medicine Physician in Cascade, Maryland. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

14303 Lake Royer Dr
Cascade, MD 21719-1602
Phone: (240) 582-0694
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1750189494
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedMarch 7, 2025
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address11116 Medical Campus Rd, Hagerstown, MD 21742-6710