MEDICAL PRACTICES OF ANTIETAM LLC – NPI #1124826862
Neurological Surgery

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

MEDICAL PRACTICES OF ANTIETAM LLC is a neurological surgeon located in HAGERSTOWN, MD. NPPES has assigned the NPI number 1124826862 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 207T00000X from the Health Care Provider Taxonomy code set, which is classified as Neurological Surgery.

The NPI profile was last updated on Mar 10, 2026. 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
1124826862
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 143
HAGERSTOWN, MD 21742-6755
Phone: (301) 790-8750 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 10, 2026

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
207T00000X
- Neurological Surgery (Primary)
208D00000X
- General Practice
207U00000X
- Nuclear Medicine

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.