# MARYLAND SPECIALTY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ULTIMA CARE LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023157781
- **Authorized official:** MRS. NAOMI A NWAGWE (BILLING/BUSINESS MANAGER)
- **Authorized official phone:** (301) 552-9495

## Contact information

- **Practice address:** 12200 ANNAPOLIS RD, SUITE\# 123, GLENN DALE, MD 20769-9182
- **Practice address phone:** (301) 552-9495
- **Practice address fax:** (301) 552-9743
- **Mailing address:** 12200 ANNAPOLIS RD, SUITE\# 123, GLENN DALE, MD 20769-9182
- **Mailing address phone:** (301) 552-9495
- **Mailing address fax:** (301) 552-9743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0040683 | MD | — |
| 207V00000X | Obstetrics & Gynecology Physician | D0040683 | MD | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 04/10/2013