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

Medical Practices of Antietam LLC

Organization Neurology Physician · NPI 1104767771

Medical Practices of Antietam LLC provides Neurology Physician services in Hagerstown, Maryland. Registered with an NPI since 2026.

In the registry since
2026
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

235 Mill St Ste 1
Hagerstown, MD 21740-6668
Phone: (301) 739-5959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X

Record details

NPI number1104767771
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedApril 6, 2026
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026
Mailing address11116 Medical Campus Rd, Hagerstown, MD 21742-6710

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