Organization
STAT WOUND CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES P VIRDEN M.D. (CEO/FOUNDER)
(775) 348-9798
Entity
Organization
Contact information
Practice address
4790 CAUGHLIN PKWY # 379, RENO, NV 89519-0907
(775) 348-9798
Mailing address
4790 CAUGHLIN PKWY # 379, RENO, NV 89519-0907
(775) 348-9798
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
7420
NV
363A00000X
Physician Assistant
PA1641
NV
Other
Enumeration date
12/09/2015
Last updated
01/07/2016
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