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General NPI Number Information
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NPI Number | 1154277341
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Entity Type | Organization
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Legal Business Name | LIFEBRIDGE COMMUNITY PHYSICIANS, INC.
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 2700 QUARRY LAKE DR STE 240
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City | BALTIMORE
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State | MD
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Zip | 21209-3769
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Country | US
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Telephone | 410-367-2590
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Fax | 410-367-2596
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Provider Business Mailing Address
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Address Line | 2700 QUARRY LAKE DR STE 240
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City | BALTIMORE
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State | MD
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Zip | 21209-3769
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Country | US
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Telephone | 410-367-2590
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Fax | 410-367-2596
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARY REBECCA WRIGHT-SISK
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Credential |
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Telephone | 410-701-4439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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