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

Medical Practices of Antietam LLC

Organization Internal Medicine Physician · NPI 1851199590

Medical Practices of Antietam LLC is an Internal Medicine Physician in Hagerstown, Maryland. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
4
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

13620 Crayton Blvd Ste C
Hagerstown, MD 21742-2335
Phone: (301) 790-9390
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Nuclear Medicine Physician Taxonomy 207U00000X

Record details

NPI number1851199590
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

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