Organization
SUMMIT MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NJIDEKA UDOCHI MD (OWNER)
(410) 245-2414
Entity
Organization
Contact information
Practice address
6310 STEVENS FOREST RD STE 200, COLUMBIA, MD 21046-1068
(410) 740-9001
(410) 740-9005
Mailing address
14520 EDGEWOODS WAY, GLENELG, MD 21737-9608
(410) 245-2414
(410) 740-9005
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685900301
—
MD
01
—
D00051897
MD LICENSE
MD
Enumeration date
06/23/2021
Last updated
12/13/2023
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