Provider Demographics
NPI:1841081908
Name:OMEGA SPECIALTY GROUP PLC
Entity type:Organization
Organization Name:OMEGA SPECIALTY GROUP PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-646-5180
Mailing Address - Street 1:18570 GRAND RIVER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2201
Mailing Address - Country:US
Mailing Address - Phone:313-646-4681
Mailing Address - Fax:313-646-4687
Practice Address - Street 1:18570 GRAND RIVER AVE STE 102
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-2201
Practice Address - Country:US
Practice Address - Phone:313-646-4681
Practice Address - Fax:313-646-4687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain