# GROUP MEDICAL CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548347206
- **Authorized official:** DR. OBIOMA S AGOMUOH M.D. (OWNER)
- **Authorized official phone:** (313) 893-8314

## Contact information

- **Practice address:** 3120 CARPENTER ST, STE 111, HAMTRAMCK, MI 48212-9802
- **Practice address phone:** (313) 893-8314
- **Practice address fax:** (313) 893-7532
- **Mailing address:** 27900 BERKSHIRE DR, SOUTHFIELD, MI 48076-4957
- **Mailing address phone:** (313) 893-8314
- **Mailing address fax:** (313) 893-7532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 4301063912 | MI | — |
| 207V00000X | Obstetrics & Gynecology Physician | 4301063912 | MI | Yes |
| 208D00000X | General Practice Physician | 4301063912 | MI | — |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 09/26/2008