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Contact Information

ODAM MEDICAL GROUP
1521 NORTHWAY DR STE 116
SAINT CLOUD, MN56303-1274
 Phone: 320-774-3800
 Fax: 320-774-3360
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

261QP2300X
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for ODAM MEDICAL GROUP

NPI Number 1902392525
LBN Legal business name ODAM MEDICAL GROUP
Authorized official ROBERT LARBI-ODAM - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/06/2018
Last updated 03/11/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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