| Owosso Medical Group, Pc | |
|
200 Health Park Drive Owosso MI 48867 | |
| (989) 723-8666 | |
| (989) 729-4983 |
| Full Name | Owosso Medical Group, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Health Park Drive, Owosso, Michigan |
| Authorized Official Name and Position | Azmy A Allam (PRESIDENT & CEO) |
| Authorized Official Contact | 9897238666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Owosso Medical Group, Pc 200 Health Park Drive Owosso MI 48867 Ph: (989) 723-8666 | Owosso Medical Group, Pc 200 Health Park Drive Owosso MI 48867 Ph: (989) 723-8666 |
| NPI Number | 1023105418 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 08/03/2011 |
| Medicare PECOS PAC ID | 5799755237 |
|---|---|
| Medicare Enrollment ID | O20040730000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023105418 | NPI | - | NPPES |
| 700G810130 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Michigan) | Primary |
| Provider Name | Ibrahim A Jawad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023092616 PECOS PAC ID: 9830097518 Enrollment ID: I20031219000729 |
| Provider Name | Khaled S Elganainy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093824351 PECOS PAC ID: 4587638093 Enrollment ID: I20051222000254 |
| Provider Name | Azmy A Allam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285603027 PECOS PAC ID: 9931179470 Enrollment ID: I20100212000250 |
| Provider Name | Deanna Marie Wagner |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1104141654 PECOS PAC ID: 4082847538 Enrollment ID: I20140507001474 |
| Provider Name | Roger Villarin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821532722 PECOS PAC ID: 4284917162 Enrollment ID: I20170130000287 |
| Provider Name | Tanya Faye Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851958078 PECOS PAC ID: 1658607155 Enrollment ID: I20190722001714 |
| Provider Name | Mallorie Skinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154920239 PECOS PAC ID: 5294123659 Enrollment ID: I20211104000543 |
| Provider Name | Eddy Elkassis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952053258 PECOS PAC ID: 9931578952 Enrollment ID: I20221214002732 |
| Provider Name | Whitney Nicole Malzahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154093425 PECOS PAC ID: 4385003672 Enrollment ID: I20230705001408 |
Owosso Medical Group Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Health Park Drive, Owosso, MI 48867 Phone: 989-723-8666 | |
Memorial Billing Company Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1480 N M52, Owosso, MI 48867 Phone: 989-723-5211 | |
Great Lakes Bay Health Centers Integrated Care Shiawassee Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1555 Industrial Drive, Owosso, MI 48867 Phone: 989-759-6464 Fax: 989-399-8233 | |
Owosso Medical Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Health Park Dr., Suite 304, Owosso, MI 48867 Phone: 989-729-4222 Fax: 989-729-4968 | |
Dot Caring Centers, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 S Washington St, Owosso, MI 48867 Phone: 989-790-3366 | |
Great Lakes Bay Health Centers Shiawassee Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 N Caledonia Dr, Owosso, MI 48867 Phone: 989-729-4848 Fax: 989-729-4849 |