| Odam Medical Group - St. Cloud | |
|
1521 Northway Dr Ste 116 Saint Cloud MN 56303-1274 | |
| (320) 774-3800 | |
| (320) 774-3360 |
| Full Name | Odam Medical Group - St. Cloud |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1521 Northway Dr Ste 116, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Robert Larbi-odam (CEO) |
| Authorized Official Contact | 6128712312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odam Medical Group - St. Cloud 1521 Northway Dr Ste 116 Saint Cloud MN 56303-1274 Ph: (320) 774-3800 | Odam Medical Group - St. Cloud 1521 Northway Dr Ste 116 Saint Cloud MN 56303-1274 Ph: (320) 774-3800 |
| NPI Number | 1902392525 |
|---|---|
| Provider Enumeration Date | 07/06/2018 |
| Last Update Date | 03/11/2025 |
| Certification Date | 03/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902392525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 261QR1300X | Clinic/center - Rural Health | () | Secondary |
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