MARYLAND SPECIALTY GROUP LLC (NPI# 1114362845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114362845 |
Entity Type | Organization |
Organization Name | MARYLAND SPECIALTY GROUP LLC |
Other Organization Name | ULTIMA CARE LLC |
Practice Address |
12200 Annapolis Rd Ste 123 Glenn Dale MD 20769-9182 |
Mailing Address |
Po Box 2056 Bowie MD 20718-2056 |
Practice Telephone | 3015529495 |
Practice Fax Number | 3015529743 |
Mailing Telephone | 3015529495 |
Mailing Fax Number | 3015529743 |
Enumeration Date | 2013-05-08 |
Last Update Date | 2013-05-08 |
Authorized Official Name | NAOMI NWAGWE (BILLING MANAGER) |
Authorized Official Telephone | 3015529495 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207V00000X | Obstetrics & Gynecology | MD | Allopathic & Osteopathic Physicians | |
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
ULTIMA CARE LLC | Former Legal Business Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023157781 | Maryland Specialty Group LLC | Internal Medicine | 12200 Annapolis Rd, Suite# 123, Glenn Dale, MD 20769-9182 | 2007-02-06 |
Street Address |
12200 ANNAPOLIS RD STE 123 |
City | GLENN DALE |
State | MD |
Zip Code | 20769-9182 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265472567 | Ikechi F Okwara | Internal Medicine | 12200 Annapolis Rd, Ste 316, Glenn Dale, MD 20769-9182 | 2006-06-07 |
1932576378 | Sports Pro Physical Therapy LLC. | Physical Therapist | 12200 Annapolis Rd, #119, Glenn Dale, MD 20769-9182 | 2015-09-01 |
1770982423 | Dominique Leary | Physical Therapist | 12200 Annapolis Rd, Glenn Dale, MD 20769-9182 | 2014-08-19 |
1659795391 | Kelsi Davis | Physical Therapist | 12200 Annapolis Rd, Suite 119, Glenn Dale, MD 20769-9182 | 2014-02-18 |
1023446002 | Wholistic Restorations LLC | Clinic/Center | 12200 Annapolis Rd, Suite 320, Glenn Dale, MD 20769-9182 | 2013-10-29 |
1124460621 | Advanced Eye Care Medical Center | Ophthalmology | 12200 Annapolis Rd, Suite 116, Glenn Dale, MD 20769-9182 | 2013-07-24 |
1962842401 | Phs Family Medicine Glenn Dale | General Acute Care Hospital | 12200 Annapolis Rd, Suite 118, Glenn Dale, MD 20769-9182 | 2013-06-28 |
1629317201 | Nikisha Gandhi | Physical Therapist | 12200 Annapolis Rd, Suite 119, Glenn Dale, MD 20769-9182 | 2013-02-02 |
1891042578 | Sherri Crable | Physical Therapist | 12200 Annapolis Rd, Suite 119, Glenn Dale, MD 20769-9182 | 2012-08-13 |
1255696647 | Nicole C Lawson | Occupational Therapist | 12200 Annapolis Rd, Suite 225, Glenn Dale, MD 20769-9182 | 2012-07-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023585676 | Ifeoma C Onyeiwu | Nurse Practitioner | Krystal Medical Associates, 12150 Annapolis Rd, Suite 100, Glenndale, MD 20769 | 2018-10-31 |
1124593983 | Olivia Kaindaneh | Technician | 10809 Glandshire Dr, Glandale, MD 20769 | 2018-10-09 |
1154810505 | Cassie Leghu | Home Health Aide | 5108 Janesdale Court, Glenn Dale, MD 20769 | 2018-05-01 |
1033659164 | Eternal Dermatology and Aesthetic Center LLC | Dermatology | 12150 Annapolis Rd Ste 213, Glenn Dale, MD 20769 | 2017-03-08 |
1881957934 | Angela Teresa Dudley Hamilton | Counselor | 11415 Old Pond Drive, Glenn Dale, MD 20769 | 2012-06-22 |
1144597923 | Jaj Health Care Services,llc | Clinical Nurse Specialist | 12150 Annapolis Rd # 205, Glenndale, MD 20769 | 2011-11-22 |
1831493030 | Evidence Physical Therapy, LLC | Physical Therapist | 12150 Annapolis Rd Ste 201, Glenn Dale, MD 20769 | 2011-01-03 |
1972731867 | Linh Nguyen | Pharmacist | 10831 Lanham Severn Rd, Glenn Dale, MD 20769 | 2009-06-30 |
1417141557 | Sharon Evette Hawks | Nutritionist | 12150 Annapolis Rd., Ste. 104, Glenn Dale, MD 20769 | 2007-08-31 |
1871715441 | Beth S Warner | Psychologist | 1107 Shoemaker Bldg., U. of Md Counseling Center, Glenn Dale, MD 20769 | 2007-05-03 |
Find all providers in zip 20769 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326678731 | Nova Vascular Specialists, LLC | Surgery | 1952 Pulaski Hwy Ste B-2, Edgewood, MD 21040-1658 | 2020-01-24 |
1033683339 | Vein and Vascular Institute of Central Maryland | Surgery | 1300 York Rd Ste 200, Lutherville, MD 21093-6090 | 2019-01-20 |
1932651312 | Elham Oumer | Surgery | 8730 Cherry Ln Ste 10, Laurel, MD 20707-6212 | 2016-11-01 |
1255742961 | Marta Vismer | Surgery | 19942 Gateshead Cir, Germantown, MD 20876-6311 | 2014-05-15 |
1023448305 | Samer Saiedy Md Gb LLC | Surgery | 1811 Crain Hwy S, Glen Burnie, MD 21061-5561 | 2013-11-22 |
1285077289 | Lucy Kupersmith | Surgery | 2002 Medical Pkwy Ste 502, Annapolis, MD 21401 | 2013-04-10 |
1316227150 | Joshua Dearing | Surgery | 7503 Surratts Rd Ste 208, Clinton, MD 20735-3358 | 2011-08-25 |
1861782492 | Norman Anthony Odyniec | Surgery | 9208 Levelle Dr, Chevy Chase, MD 20815-5604 | 2011-04-16 |
1730480872 | James F Mcguckin Md of Md Pa | Surgery | 3450 Old Washington Rd Ste 202, Waldorf, MD 20602-3250 | 2010-11-05 |
1194952796 | James M Salander, Md Pa | Surgery | 11119 Rockville Pile, #204, Rockville, MD 20852 | 2009-06-22 |
Find all providers with the same taxonomy |
City | GLENN DALE |
Zip Code | 20769 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.