Organization Name: | GLOBAL WOUND CARE |
NPI Number: | 1003956210 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SIVAKUMAR JAYABALAN (OWNER / CEO) |
Mailing Address: | 200 Bond St Suite 109 Royston |
State: | GA US |
Postal Code: | 306624137 |
Phone Number: | 7062454040 |
Fax Number: | 7062454070 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 09/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 028075 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |