Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Antietam Pediatric and Adolescent Care, LLC

Organization Pediatric Adolescent Medicine Physician · NPI 1780627810

Antietam Pediatric and Adolescent Care, LLC provides Pediatric Adolescent Medicine Physician services in Hagerstown, Maryland. Licensed in Maryland. Registered with an NPI since 2006.

Licensed in
MD
In the registry since
2006
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

1161 Omega Dr
Hagerstown, MD 21740-5574
Phone: (301) 393-2600
Fax: (210) 393-2614
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X (MD)

Record details

NPI number1780627810
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leon Weaver — Partner · (301) 393-2600
NPI enumeratedJune 14, 2006
Last updated in NPPESJuly 21, 2022
Mailing address1161 Omega Dr, Hagerstown, MD 21740-5574

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