MEDICAL PRACTICES OF ANTIETAM, LLC (NPI# 1558430843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558430843 |
| Entity Type | Organization |
| Organization Name | MEDICAL PRACTICES OF ANTIETAM, LLC |
| Practice Address |
11110 Medical Campus Road Suite 229 Hagerstown MD 21742 |
| Practice Telephone | 3016654531 |
| Practice Fax Number | 3017909103 |
| Mailing Telephone | 3016654531 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2019-10-30 |
| Authorized Official Name | THOMAS CHAN (CFO) |
| Authorized Official Telephone | 3017908103 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
11110 MEDICAL CAMPUS ROAD SUITE 229 |
| City | HAGERSTOWN |
| State | MD |
| Zip Code | 21742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598725442 | Scott P Worrell | Orthopaedic Surgery | 11110 Medical Campus Road, Suite 205, Hagerstown, MD 21742 | 2006-03-24 |
| 1740629542 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 11110 Medical Campus Road, Suite 205, Hagerstown, MD 21742 | 2013-06-14 |
| 1447419627 | Victoria Marie Saah Giffi | Internal Medicine | 11110 Medical Campus Road, Suite 130, Hagerstown, MD 21742 | 2008-06-03 |
| 1912073644 | Per K Houmann | Dentist | 11110 Medical Campus Road, Robinwood Dental Ctr Suite 148, Hagerstown, MD 21742 | 2006-11-27 |
| 1912008764 | Kristin M Horman | Dentist | 11110 Medical Campus Road, Suite 148, Hagerstown, MD 21742 | 2006-09-26 |
| 1164523916 | Harold E Butler | Dentist | 11110 Medical Campus Road, Suite 148, Hagerstown, MD 21742 | 2006-09-26 |
| 1558396697 | Brian W. Moyer | Anesthesiology | 11110 Medical Campus Road, Suite 200, Hagerstown, MD 21742 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154950251 | Caleb Lougheed | Student in an Organized Health Care Education/Training Program | Meritus Family Medicine Residency Program, 11110 Medical Campus Road, Suite 200, Hagerstown, MD 21742 | 2020-04-02 |
| 1770054900 | Katherine E Spann | Physician Assistant | Meritus Medical Center, 11116 Medical Campus Road, Hagerstown, MD 21742 | 2018-12-16 |
| 1760988950 | Kelli Jones | Nurse Anesthetist, Certified Registered | 11116 Medical Center, Hagerstown, MD 21742 | 2018-04-05 |
| 1740706324 | Michael E. Anderson, Dds, PC | Dentist | 18709 Crestwood Drive, Hagerstown, MD 21742 | 2017-08-16 |
| 1407387384 | Cynthia Brendle | Physical Therapy Assistant | 19800 Tranquility Circle, Robinwood Campus, Hagerstown, MD 21742 | 2017-03-23 |
| 1326411877 | Structural Elements, LLC | Acupuncturist | 13214 Fountainhead Plaza, Hagerstown, MD 21742 | 2015-11-05 |
| 1386057396 | Ma Pamela Borden | Occupational Therapist | 506 Lynnehaven Drive, Apartment G, Hagerstown, MD 21742 | 2014-06-06 |
| 1275971251 | Arti Babubhai Patel | Denturist | 13133 Gentry Drive, Hagerstown, MD 21742 | 2013-06-12 |
| 1063859551 | Premise Health of Maryland Medical P C | Clinic/Center | 13403 Volvo Way, Medical Suite, Hagerstown, MD 21742 | 2013-05-24 |
| 1386938363 | Rocky Mountain Holdings LLC | Ambulance | 18539 Henson Blvd, Hagerstown, MD 21742 | 2011-06-07 |
| Find all providers in zip 21742 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356704571 | Healthcare Services Corportation | General Practice | 40 Elgin Blvd, Suite 102, Hagerstown, MD 21740-5304 | 2016-04-04 |
| 1447231121 | Rose Marie Chan | General Practice | 1500 Pennsylvania Ave, Hagerstown, MD 21742-3112 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490950 | Arlene Elizabeth George | General Practice | 1500 W Perimeter Rd Ste 4350, Jb Andrews, MD 20762-6604 | 2020-09-04 |
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1548889447 | Canary Doctor LLC | General Practice | 8904 Maxwell Dr, Potomac, MD 20854-3124 | 2020-04-10 |
| 1083247894 | Medstar Medical Group II LLC | General Practice | 9101 Franklin Square Drive, Ste 200, Medical Arts Building, Baltimore, MD 21237-4072 | 2020-02-20 |
| 1881239838 | Avicention LLC | General Practice | 350c Fortune Ter # 227, Potomac, MD 20854-2980 | 2019-11-14 |
| 1972148963 | My Primary Care | General Practice | 826 Washington Rd Ste 110, Westminster, MD 21157-5779 | 2019-11-13 |
| 1619512837 | David Newsome | General Practice | 12305 Sandalwood Lane, Silver Spring, MD 20904 | 2019-11-12 |
| 1720623242 | Assured Access Medical Associates Inc. | General Practice | 7221 Hanover Pkwy Ste C, Greenbelt, MD 20770-2022 | 2019-11-07 |
| 1780240671 | Capstone Treatment Center, Inc | General Practice | 1133 E West Hwy Apt 204e, Silver Spring, MD 20910-4804 | 2019-05-15 |
| 1861058935 | Revive Treatment Center Inc | General Practice | 1133 E West Hwy Apt 1515w, Silver Spring, MD 20910-6833 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
| City | HAGERSTOWN |
| Zip Code | 21742 |
Please comment or provide details below to improve the information on MEDICAL PRACTICES OF ANTIETAM, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.