# OMNI FAMILY MEDICAL SC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OMNI FAMILY MEDICAL SC
- **Other names:** Omni Family Medical SC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033767017
- **Legal business name:** OMNI FAMILY MEDICAL SC
- **Authorized official:** KWESI GRANT-ACQUAH (MD)
- **Authorized official phone:** (414) 374-9575

## Contact information

- **Practice address:** 7810 W GOOD HOPE RD, MILWAUKEE, WI 53223-4518
- **Practice address phone:** (414) 586-9255
- **Practice address fax:** (414) 760-6219
- **Mailing address:** 7810 W GOOD HOPE RD, MILWAUKEE, WI 53223-4518
- **Mailing address phone:** (414) 586-9255
- **Mailing address fax:** (414) 760-6219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2019
- **Last updated:** 09/03/2019