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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1396543930
Allergy & Immunology in Hagerstown, MD

Active since March 07, 2025
1125 DIAMOND DR, HAGERSTOWN, MD 21740(301) 790-1482 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Medical Practices Of Antietam Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDICAL PRACTICES OF ANTIETAM LLC (NPI 1396543930) is a healthcare organization registered as an allergy & immunology in Hagerstown, Maryland and active in the NPI registry since March 2025. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1396543930
Entity TypeOrganization
Primary Taxonomy207K00000X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address1125 DIAMOND DRHagerstown, MD 21740-5857
Mailing Address11116 Medical Campus RdHagerstown, MD 21742-6710
Phone(301) 790-1482
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateMarch 7, 2025
NPPES CertifiedMarch 7, 2025
✔ NPI 1396543930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
Definition
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.
Also ListedAllergy & Immunology · AllergyTaxonomy 207KA0200X
Also ListedPediatrics · Pediatric Allergy/ImmunologyTaxonomy 2080P0201X
Also ListedGeneral PracticeTaxonomy 208D00000X
1125 DIAMOND DR, Hagerstown, MD 21740
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUSTINA WORKMAN FNP-C
Nurse Practitioner (Family)
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 790-1482
DR. SAILAJA NOOTHETI MD
Allergy & Immunology
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 790-1482
DR. RICHARD JOSEPH PORAC D.D.S.
Dentist (General Practice)
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 739-8081
DRS MAURIELLO AND ORFAN PA
Allergy & Immunology
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 790-1482
CHARMAINE PFINAYI
Physician Assistant
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 790-1482
DRS. PORAC & BACHTELL FAMILY DENTISTRY, LLC
Clinic/Center (Dental)
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 739-8081
DOUGLAS ALLEN BACHTELL II DDS
Dentist (General Practice)
1125 DIAMOND DR
HAGERSTOWN, MD 21740
Washington County (301) 739-8081

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medical Practices Of Antietam LLC's NPI number?

The NPI number for Medical Practices Of Antietam LLC is 1396543930. It was assigned to this organization in the NPPES registry on March 7, 2025.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 1125 Diamond Dr, Hagerstown, MD 21740. The listed phone number is (301) 790-1482.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.