Organization
WOUND CARE CLINICS OF AMERICA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR UBOM (OWNER DO)
(248) 557-8800
Entity
Organization
Contact information
Practice address
24111 SOUTHFIELD RD, SOUTHFIELD, MI 48075-2841
(248) 557-8800
(248) 557-8860
Mailing address
24111 SOUTHFIELD RD, SOUTHFIELD, MI 48075-2841
(248) 557-8800
(248) 557-8860
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
5101007418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0658216575
BCBS
MI
05
—
306404811
—
MI
Enumeration date
05/28/2008
Last updated
06/18/2008
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