Organization
OMNI FAMILY MEDICAL SC
Active
Other names
Omni Family Medical SC
Organization subpart
No
Provider details
NPI number
Authorized official
MURTIS GRANT-ACQUAH (OFFICE MANAGER)
(414) 374-9575
Entity
Organization
Contact information
Practice address
7810 W GOOD HOPE RD, MILWAUKEE, WI 53223-4518
(414) 586-9255
Mailing address
7810 W GOOD HOPE RD, MILWAUKEE, WI 53223-4518
(414) 586-9255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6454820
WI
305S00000X
Point of Service
6454820
WI
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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