Group Medical Clinic PLLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301063912 Issued in MI

Legal business name

GROUP MEDICAL CLINIC PLLC

Practice address

3120 Carpenter St
Ste 111
Hamtramck, MI 48212-9802

Phone

(313) 893-8314

Fax

(313) 893-7532

NPI assigned

Nov 1, 2006

Last updated

Sep 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Obioma S Agomuoh, M.D.NPI 1023118809

Title

Owner

Phone

(313) 893-8314

Specialties & licenses 3

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Obioma S Agomuoh, M.D.

  • Family Medicine Physician
  • Hamtramck, MI
  • NPI 1023118809
  NPD (past) Authorized official
• Bridget Chinyere Agomuoh, MD

  • Pediatrics Physician
  • Westland, MI
  • NPI 1245278977
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1548347206",
    "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": "STE 111",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482129802",
            "telephone_number": "313-893-8314",
            "fax_number": "313-893-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "AGOMUOH",
        "authorized_official_first_name": "OBIOMA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-893-8314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "MI",
            "license": "4301063912",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301063912",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301063912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LIC",
            "identifier": "4301063912",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4149140 10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Hamtramck, MI
• Providers in Hamtramck, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.