Organization
OPTIMIZE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KAMAU NGUGI CRNP-C (OWNER/SOLE MEMBER)
(443) 248-1929
Entity
Organization
Contact information
Practice address
1314 BEDFORD AVE STE 113, PIKESVILLE, MD 21208-3737
(443) 868-7101
(443) 868-7956
Mailing address
PO BOX 72098, ROSEDALE, MD 21237-8098
(443) 868-7101
(443) 868-7956
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R179125
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444017000
—
MD
Enumeration date
12/29/2017
Last updated
09/16/2022
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