Obioma S Agomuoh, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4030063912 Issued in MI

Practice address

3120 Carpenter St
Suite 111
Hamtramck, MI 48212-9802

Phone

(313) 893-8314

Fax

(313) 893-7532

NPI assigned

Sep 22, 2006

Last updated

Jan 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Group Medical Clinic PLLC

  • Obstetrics & Gynecology Physician
  • Hamtramck, MI
  • NPI 1548347206
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1023118809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27900 BERKSHIRE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764957",
            "telephone_number": "313-893-8314",
            "fax_number": "313-893-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 CARPENTER ST",
            "address_2": "SUITE 111",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482129802",
            "telephone_number": "313-893-8314",
            "fax_number": "313-893-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOMUOH",
        "first_name": "OBIOMA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4030063912",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4030063912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4149140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Adler, DPM
• Adult & Pediatric M D PLLC
• Advance Care RX Pharmacy
• Advanced Medical Equipment Inc
• Advanced Medical Equipment Inc
• Huma Ayyub Ahmad
• Jamil Ahmed
• Motahar Hossain Ahmed, M.D.
• Mujahid Ahmed
• Mursala Naji Ahmed, R.PH.

• Family Medicine Physician in Hamtramck, MI
• Providers in Hamtramck, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.