Individual
MARYAM SOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
239 N STATE RD STE 101, OWOSSO, MI 48867-9075
(989) 743-3415
(989) 743-6180
Mailing address
239 N STATE RD STE 101, OWOSSO, MI 48867-9075
(989) 743-3415
(989) 743-6180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301115221
MI
207Q00000X
Family Medicine Physician
Primary
4301504106
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437644127
—
MI
Enumeration date
06/26/2018
Last updated
08/04/2021
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