| Doctor Name: | DR. OBIOMA S AGOMUOH |
| NPI Number: | 1023118809 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 4030063912 |
| Business Practice Address: | 3120 Carpenter St Suite 111 Hamtramck, MI - 482129802 |
| Business Phone Number: | 3138938314 |
| Business Fax Number: | 3138937532 |
| Mailing Address: | 27900 Berkshire Dr, SOUTHFIELD |
| State: | MI |
| Postal Code: | 480764957 |
| Phone Number: | 3138938314 |
| Fax Number: | 3138937532 |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 4030063912 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |