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

Medical Practices of Antietam LLC

Organization General Practice Physician · NPI 1821958083

Medical Practices of Antietam LLC provides General Practice Physician services in Hagerstown, Maryland. Registered with an NPI since 2025.

In the registry since
2025
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) 665-4920
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1821958083
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Repac — Cfo · (301) 790-9351
NPI enumeratedNovember 12, 2025
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025
Mailing address11110 Medical Campus Rd Ste 147, Hagerstown, MD 21742-6755

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