| Optimum Medical Group Llc | |
|
3240 Belair Rd Baltimore MD 21213-1228 | |
| (443) 985-6011 | |
| Not Available |
| Full Name | Optimum Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3240 Belair Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Blessing Gabriel (PROVIDER) |
| Authorized Official Contact | 4439856011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Medical Group Llc 9014 Amber Oaks Way Owings Mills MD 21117-5036 Ph: (443) 985-6011 | Optimum Medical Group Llc 3240 Belair Rd Baltimore MD 21213-1228 Ph: (443) 985-6011 |
| NPI Number | 1326655283 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 01/29/2024 |
| Medicare PECOS PAC ID | 7517386758 |
|---|---|
| Medicare Enrollment ID | O20201007002138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326655283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Blessing Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629504477 PECOS PAC ID: 8224395157 Enrollment ID: I20171206002803 |
| Provider Name | Nwanneka Ndeche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104414457 PECOS PAC ID: 7012312077 Enrollment ID: I20210830001108 |
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