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General NPI Number Information
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NPI Number | 1417124454
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Entity Type | Organization
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Legal Business Name | SHIAWASSEE COUNTY MEDICAL GROUP
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 208 N SHIAWASSEE ST
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City | OWOSSO
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State | MI
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Zip | 48867-2755
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Country | US
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Telephone | 989-725-2667
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Fax | 989-725-2383
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Provider Business Mailing Address
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Address Line | 208 N SHIAWASSEE ST
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City | OWOSSO
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State | MI
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Zip | 48867-2755
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Country | US
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Telephone | 989-725-2667
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Fax | 989-725-2383
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EKRAM M SMITH
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Credential | MD
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Telephone | 989-725-2667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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