MEDICAL PRACTICES OF ANTIETAM LLC – NPI #1700684347
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

MEDICAL PRACTICES OF ANTIETAM LLC is a provider located in HAGERSTOWN, MD. NPPES has assigned the NPI number 1700684347 to MEDICAL PRACTICES OF ANTIETAM LLC on March 07, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RH0003X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Hematology & Oncology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MEDICAL PRACTICES OF ANTIETAM LLC below.

NPI Profile for
MEDICAL PRACTICES OF ANTIETAM LLC

NPI Number
1700684347
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MEDICAL PRACTICES OF ANTIETAM LLC
Primary location
11110 MEDICAL CAMPUS RD STE 130
HAGERSTOWN, MD 21742-6799
Phone: (301) 665-4710 Fax:
Mailing address
11116 MEDICAL CAMPUS RD
HAGERSTOWN, MD 21742-6710
Phone: Fax:
Organization Subpart
No
Authorized Official
JOSHUA REPAC
CFO
Phone: (301) 790-9351
Updated
Certification Date
Mar 07, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RH0003X
- Internal Medicine / Hematology & Oncology (Primary)
208D00000X
- General Practice

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.