| Maryland Specialty Group Llc | |
|
12200 Annapolis Rd Suite# 123 Glenn Dale MD 20769-9182 | |
| (301) 552-9495 | |
| (301) 552-9743 |
| Full Name | Maryland Specialty Group Llc |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 12200 Annapolis Rd, Glenn Dale, Maryland |
| Authorized Official Name and Position | Naomi A Nwagwe (BILLING/BUSINESS MANAGER) |
| Authorized Official Contact | 3015529495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Specialty Group Llc 12200 Annapolis Rd Suite# 123 Glenn Dale MD 20769-9182 Ph: (301) 552-9495 | Maryland Specialty Group Llc 12200 Annapolis Rd Suite# 123 Glenn Dale MD 20769-9182 Ph: (301) 552-9495 |
| NPI Number | 1023157781 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 04/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023157781 | NPI | - | NPPES |
| G01686 | Other | DC | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0040683 (Maryland) | Secondary |
| 207V00000X | Obstetrics & Gynecology | D0040683 (Maryland) | Primary |
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