Organization
WOUND CARE CLINICS OF AMERICA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR O UBOM DO (OWNER)
(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
363L00000X
Nurse Practitioner
4704127273
MI
363L00000X
Nurse Practitioner
4704154666
MI
363L00000X
Nurse Practitioner
4704170335
MI
363L00000X
Nurse Practitioner
Primary
4704217515
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4661052-11
—
MI
05
—
4661061-11
—
MI
05
—
4737894-11
—
MI
05
—
4868706-11
—
MI
01
—
500F324120
BCBSM
MI
Enumeration date
12/05/2006
Last updated
06/18/2008
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