Organization
OWOSSO MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AZMY A ALLAM MD (PRESIDENT & CEO)
(989) 723-8666
Entity
Organization
Contact information
Practice address
200 HEALTH PARK DRIVE, OWOSSO, MI 48867
(989) 723-8666
(989) 729-4983
Mailing address
200 HEALTH PARK DRIVE, OWOSSO, MI 48867
(989) 723-8666
(989) 729-4983
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700G810130
BLUE CROSS
MI
Enumeration date
10/06/2006
Last updated
08/03/2011
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