Healthcare Provider Details

I. General information

NPI: 1891632345
Provider Name (Legal Business Name): WOUND WELLNESS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 STATE BRIDGE RD STE G39
JOHNS CREEK GA
30097-8220
US

IV. Provider business mailing address

5805 STATE BRIDGE RD STE G39
JOHNS CREEK GA
30097-8220
US

V. Phone/Fax

Practice location:
  • Phone: 470-797-6566
  • 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 State

VIII. Authorized Official

Name: HARICHARAN TEJA MADDURI
Title or Position: PRESIDENT
Credential:
Phone: 678-360-0873