Organization
MARYLAND SPECIALTY GROUP LLC
Active
Other names
ULTIMA CARE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAOMI A NWAGWE (BILLING/BUSINESS MANAGER)
(301) 552-9495
Entity
Organization
Contact information
Practice address
12200 ANNAPOLIS RD, SUITE# 123, GLENN DALE, MD 20769-9182
(301) 552-9495
(301) 552-9743
Mailing address
12200 ANNAPOLIS RD, SUITE# 123, GLENN DALE, MD 20769-9182
(301) 552-9495
(301) 552-9743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0040683
MD
207V00000X
Obstetrics & Gynecology Physician
Primary
D0040683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G01686
PTAN
DC
Enumeration date
02/06/2007
Last updated
04/10/2013
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