| NPI | 1033767017 |
|---|---|
| Former Legal Business Name | OMNI FAMILY MEDICAL SC |
| Entity Type | Organization |
| Authorized Contact | KWESI GRANT-ACQUAH Md 414-374-9575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |