| Woundtech Of Arizona | |
|
11811 N Tatum Blvd Ste 1075 Phoenix AZ 85028-1661 | |
| (954) 923-7440 | |
| (954) 923-1299 |
| Full Name | Woundtech Of Arizona |
|---|---|
| Speciality | Internal Medicine |
| Location | 11811 N Tatum Blvd Ste 1075, Phoenix, Arizona |
| Authorized Official Name and Position | Minghsun Liu (CEO) |
| Authorized Official Contact | 9549237440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woundtech Of Arizona 200 S Park Rd Ste 200 Hollywood FL 33021-8541 Ph: (954) 923-7440 | Woundtech Of Arizona 11811 N Tatum Blvd Ste 1075 Phoenix AZ 85028-1661 Ph: (954) 923-7440 |
| NPI Number | 1316454945 |
|---|---|
| Provider Enumeration Date | 01/04/2018 |
| Last Update Date | 05/05/2023 |
| Medicare PECOS PAC ID | 2365703360 |
|---|---|
| Medicare Enrollment ID | O20180308002119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316454945 | NPI | - | NPPES |
| 58473 | Other | AZ | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Tanya N Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033468202 PECOS PAC ID: 6800041013 Enrollment ID: I20130219000144 |
| Provider Name | Kristi Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316458508 PECOS PAC ID: 9133485238 Enrollment ID: I20171106002159 |
| Provider Name | Serena Cherese Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306357397 PECOS PAC ID: 7517224306 Enrollment ID: I20171204001540 |
| Provider Name | Jeffrey Lee Galitz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861485112 PECOS PAC ID: 2567358484 Enrollment ID: I20180308002353 |
| Provider Name | Hillary Dawn Tash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629588348 PECOS PAC ID: 2365704400 Enrollment ID: I20180329000988 |
| Provider Name | Natalie Kahle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720560501 PECOS PAC ID: 1254671381 Enrollment ID: I20190327001001 |
| Provider Name | Genevieve Ijeoma Onyirimba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407323710 PECOS PAC ID: 4082949524 Enrollment ID: I20190705000712 |
| Provider Name | Maryann Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205394947 PECOS PAC ID: 5991032856 Enrollment ID: I20190815000292 |
| Provider Name | Minghsun Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518096270 PECOS PAC ID: 3577626803 Enrollment ID: I20200421000866 |
| Provider Name | Leena R Tarin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194289280 PECOS PAC ID: 3577994383 Enrollment ID: I20200512000655 |
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