| Organization Name: | LIFEBRIDGE COMMUNITY PHYSICIANS, INC. |
| NPI Number: | 1194170027 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY WRIGHT-SISK (DIRECTOR) |
| Mailing Address: | 8600 Liberty Rd 3rd Floor Randallstown |
| State: | MD US |
| Postal Code: | 211334707 |
| Phone Number: | 4105214211 |
| Fax Number: | |
| NPI Enumeration Date: | 04/28/2016 |
| NPI Last Update Date: | 04/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |