Organization
ODAM COMMUNITY CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LARBI-ODAM MD, MPH (MEDICAL DIRECTOR)
(952) 228-0420
Entity
Organization
Contact information
Practice address
2015 CHICAGO AVE, MINNEAPOLIS, MN 55404-2813
(763) 285-4916
(612) 345-4191
Mailing address
2015 CHICAGO AVE, MINNEAPOLIS, MN 55404-2813
(763) 285-4916
(612) 345-4191
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/21/2022
Last updated
03/31/2023
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