| Organization Name: | OWOSSO MEDICAL GROUP, PC |
| NPI Number: | 1023105418 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AZMY A ALLAM (PRESIDENT & CEO) |
| Mailing Address: | 200 Health Park Drive Owosso |
| State: | MI US |
| Postal Code: | 48867 |
| Phone Number: | 9897238666 |
| Fax Number: | 9897294983 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 08/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |