Healthcare Provider Details

I. General information

NPI: 1922825538
Provider Name (Legal Business Name): MEDICUS ADVANCED WOUND SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6944 E BROADWAY RD
MESA AZ
85208-1916
US

IV. Provider business mailing address

6991 E CAMELBACK RD STE D300
SCOTTSDALE AZ
85251-2492
US

V. Phone/Fax

Practice location:
  • Phone: 480-716-8514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHARJEEL ISRAR
Title or Position: MANAGER
Credential:
Phone: 480-716-8514