Organization
ODAM MEDICAL GROUP
Active
Other names
ODAM MEDICAL GROUP - ST. CLOUD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LARBI-ODAM (CEO)
(612) 871-2312
Entity
Organization
Contact information
Practice address
1521 NORTHWAY DR STE 116, SAINT CLOUD, MN 56303-1274
(320) 774-3800
(320) 774-3360
Mailing address
1521 NORTHWAY DR STE 116, SAINT CLOUD, MN 56303-1274
(320) 774-3800
(320) 774-3360
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
07/06/2018
Last updated
03/11/2025
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