| Organization Name: | GROUP MEDICAL CLINIC PLLC |
| NPI Number: | 1548347206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OBIOMA S AGOMUOH (OWNER) |
| Mailing Address: | 3120 Carpenter St Ste 111 Hamtramck |
| State: | MI US |
| Postal Code: | 482129802 |
| Phone Number: | 3138938314 |
| Fax Number: | 3138937532 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 09/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | 4301063912 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |