Odam Medical Group
Clinic/Center, Primary Care in Saint Cloud, MN. Organization (NPI-2).
NPI number1902392525
StatusActive
Last updated in NPPESMar 11, 2025
Details
- NPI
- 1902392525
- Entity type
- Organization (NPI-2)
- Legal business name
- Odam Medical Group
- Organization subpart
- No
- Enumeration date
- Jul 6, 2018
- Certification date
- Mar 11, 2025
- Last updated
- Mar 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 261QR1300X | Clinic/Center, Rural Health | – | – |
Other names
- Odam Medical Group - St. Cloud (Other Name)
Practice location
1521 Northway Dr Ste 116Saint Cloud, MN 56303-1274
Phone 320-774-3800 · Fax 320-774-3360
Mailing address
1521 Northway Dr Ste 116Saint Cloud, MN 56303-1274
Phone 320-774-3800 · Fax 320-774-3360
Other practice locations
435 Main St W Ste B
Rice, MN 56367-9516
Rice, MN 56367-9516
Phone 320-774-3800 · Fax 320-774-3360
Authorized official
Robert Larbi-Odam
Ceo
6128712312
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