Pediatrics, Adolescent Medicine
LIFEBRIDGE SUBURBAN PHYSICIAN GROUP II LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1194170027 · enumerated 2016-04-28 · record updated 2021-08-31. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: MARY WRIGHT-SISK, Director · (443) 422-9941
Other names: DR. JACALYN BLACKWELL-WHITE
Addresses and phones
- Practice location 5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD, 21133-5100 (410) 521-7337 Fax (410) 521-7377 Google Maps Apple Maps OpenStreetMap
- Mailing address 3527 N ROLLING RD, # 1, BALTIMORE, MD, 21244-2223 (410) 521-7337 Google Maps Apple Maps OpenStreetMap
Specialties
- Pediatrics, Adolescent Medicine 2080A0000X · Primary
In this directory
MD Baltimore County Randallstown Pediatrics, Adolescent Medicine
Locations and evidence
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Practice location
RANDALLSTOWN, MD, 211335100
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.