National Provider Identifier Database

ANTIETAM FAMILY HEALTH LLC
Family


Contact Information

ANTIETAM FAMILY HEALTH, LLC
427 E PATRICK ST
FREDERICK, MD21701-5777
Phone: 240-203-8864
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X
Psychiatric/Mental Health 363LP0808X

* Indicates primary specialty

NPI Profile & details for ANTIETAM FAMILY HEALTH, LLC

NPI Number 1316724842
Legal business name
LBN
ANTIETAM FAMILY HEALTH, LLC
Authorized official MARK RONCONE - (OWNER/PROVIDER)
Entity Organization
Organization subpart No
Enumeration date 09/08/2023
Last updated 02/24/2026 - About 3 months ago
Sole proprietor1 Not specified
Identifiers n/a

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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