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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1467391706
Radiology - Vascular & Interventional Radiology in Hagerstown, MD

Active since March 25, 2026
11110 MEDICAL CAMPUS RD STE 143, HAGERSTOWN, MD 21742(301) 714-4350 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2026, Mar 25, 2026 (2 updates tracked since 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 1467391706) is a healthcare organization registered as a vascular & interventional radiology in Hagerstown, Maryland and active in the NPI registry since March 2026. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1467391706
Entity TypeOrganization
Primary Taxonomy2085R0204X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address11110 MEDICAL CAMPUS RD STE 143Hagerstown, MD 21742-6755
Mailing Address11116 Medical Campus RdHagerstown, MD 21742-6710
Phone(301) 714-4350
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateMarch 25, 2026
Last NPPES UpdateApril 2, 20262 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1467391706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
11110 MEDICAL CAMPUS RD STE 143, Hagerstown, MD 21742
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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 18

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

CRISTINA BUTLER-LUGO CRNP
Nurse Practitioner
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
SAMI SHOUCAIR
Surgery
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
ASIM SHABBIR
Surgery (Trauma Surgery)
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
MEDICAL PRACTICES OF ANTIETAM LLC
Neurological Surgery
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 790-8750
MS. MARINA MARLENE OVERBY NP
Nurse Practitioner (Family)
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
MEGAN LEANNE SICHLER
Physician Assistant
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
DR. SUSAN MARGUERITE SHARPE M.D.
Surgery (Surgical Oncology)
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
DR. CHUCKIA NICOLE BROWN-TISDALE M.D.
Internal Medicine
11110 MEDICAL CAMPUS RD STE 143
HAGERSTOWN, MD 21742
Washington County (301) 714-4175

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 1467391706. It was assigned to this organization in the NPPES registry on March 25, 2026.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 11110 Medical Campus Rd Ste 143, Hagerstown, MD 21742. The listed phone number is (301) 714-4350.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.