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Contact Information

MEDICAL PRACTICES OF ANTIETAM LLC
1125 DIAMOND DR
HAGERSTOWN, MD21740-5857
 Phone: 301-790-1482
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Allergy

207KA0200X 03 Physician/Allergy/ Immunology
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Pediatric Allergy/Immunology

2080P0201X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MEDICAL PRACTICES OF ANTIETAM LLC · (Female)

NPI Number 1396543930
Status Active
Credentials
Entity Individual
Enumeration date 03/07/2025
Last updated 03/07/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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