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

Medical Practices of Antietam LLC

Organization Gynecology Physician · NPI 1710700042

Medical Practices of Antietam LLC provides Gynecology Physician services in Hagerstown, Maryland. Registered with an NPI since 2024.

In the registry since
2024
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 Ste 147
Hagerstown, MD 21742-6755
Phone: (301) 791-5555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gynecology Physician (primary) Taxonomy 207VG0400X

Record details

NPI number1710700042
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedNovember 5, 2024
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026
Mailing address1130 Professional Ct, Hagerstown, MD 21740-5852

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