Organization
ESSENTIAL MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR MADISON (OWNER)
(313) 826-0171
Entity
Organization
Contact information
Practice address
3120 CARPENTER ST STE 207, HAMTRAMCK, MI 48212-2771
(313) 826-0171
Mailing address
3120 CARPENTER ST STE 207, HAMTRAMCK, MI 48212-2771
(313) 826-0171
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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