Organization
ADVANCED WOUND CARE & PLASTIC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY TAMIR MD, FAPWCA (PHYSICIAN/PRESIDENT)
(316) 201-8573
Entity
Organization
Contact information
Practice address
902 N HILLSIDE ST, WICHITA, KS 67214-3220
(316) 425-5016
(316) 425-0422
Mailing address
902 N HILLSIDE ST, WICHITA, KS 67214-3220
(316) 425-5016
(316) 425-0422
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-32928
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871749663
INDIVIDUAL NPI
KS
Enumeration date
04/07/2009
Last updated
11/07/2013
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