| Valley Wound Care Specialists | |
|
6320 W Union Hills Drive Building A, Suite 140 Glendale AZ 85308 | |
| (480) 347-0844 | |
| (480) 347-0885 |
| Full Name | Valley Wound Care Specialists |
|---|---|
| Speciality | Internal Medicine |
| Location | 6320 W Union Hills Drive, Glendale, Arizona |
| Authorized Official Name and Position | Michael Lawrence Berman (PRESIDENT) |
| Authorized Official Contact | 4803470844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Wound Care Specialists 6320 W Union Hills Drive Building A, Suite 140 Glendale AZ 85308 Ph: (480) 347-0844 | Valley Wound Care Specialists 6320 W Union Hills Drive Building A, Suite 140 Glendale AZ 85308 Ph: (480) 347-0844 |
| NPI Number | 1457303539 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 02/24/2021 |
| Medicare PECOS PAC ID | 8820027352 |
|---|---|
| Medicare Enrollment ID | O20050804001242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457303539 | NPI | - | NPPES |
| AZ0784280 | Other | AZ | BCBS |
| 464173 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael L Berman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285635078 PECOS PAC ID: 8820026248 Enrollment ID: I20050727001006 |
| Provider Name | Michael N Desvigne |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1356336317 PECOS PAC ID: 0648297887 Enrollment ID: I20060822000617 |
| Provider Name | Kristina A Fawcett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225307754 PECOS PAC ID: 0547422339 Enrollment ID: I20120423000792 |
| Provider Name | Pamela Jeanne Waychoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578966693 PECOS PAC ID: 8729393053 Enrollment ID: I20150817000983 |
| Provider Name | Camile Fabrigail Solidum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437623717 PECOS PAC ID: 5698001774 Enrollment ID: I20190726001979 |
| Provider Name | Kurt Adam Holifield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033819461 PECOS PAC ID: 0749625325 Enrollment ID: I20240305003590 |
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