Healthcare Provider Details

I. General information

NPI: 1508447236
Provider Name (Legal Business Name): WOUND CARE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 BATH RD
BRUNSWICK ME
04011-2651
US

IV. Provider business mailing address

310 BATH RD
BRUNSWICK ME
04011-2651
US

V. Phone/Fax

Practice location:
  • Phone: 207-725-4008
  • Fax: 207-725-5749
Mailing address:
  • Phone: 207-725-4008
  • Fax: 207-725-5749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ANGELIQUE BETH SARAYDARIAN
Title or Position: MANAGER
Credential: RN
Phone: 207-725-4008