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NPI Code Detail

MEDICARE: OMG#1PC

MEDICARE: OMG#1PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician
2208100000XPhysical Medicine & Rehabilitation Physician
32085U0001XDiagnostic Ultrasound Physician
4207RC0000XCardiovascular Disease Physician
52085R0204XVascular & Interventional Radiology Physician
6207U00000XNuclear Medicine Physician
7207RM1200XMagnetic Resonance Imaging (MRI) Internal Medicine Physician
82085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1033384490
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMG#1PC
Provider Business Mailing Address
First Line : 29992 NORTHWESTERN HWY STE C
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-3292
Country : US
Telephone Number : 248-851-1430
Fax Number : 248-851-5319
Provider Business Practice Location Address
First Line : 27650 DEQUINDRE RD STE 1000
Second Line :
City : WARREN
State : MI
Zip : 48092-2818
Country : US
Telephone Number : 248-544-9050
Fax Number : 248-544-2331
Authorized Official
Title or Position : PRESIDENT
Name : DR. HAROLD MARGOLIS
Credential : D.O.
Telephone Number : 248-851-1430
Provider Enumeration Date : 04/28/2008
Last Update Date : 05/18/2026

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Practice Phone: 248-544-9050
Practice Fax: 248-544-2331
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1376486951 — SEOHYUN KIM DO
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Directions to “OMG#1PC ” Practice Location

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