Healthcare Provider Details

I. General information

NPI: 1174486807
Provider Name (Legal Business Name): WOUND CARE MEDICAL OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 MARKET AVE N STE 100
CANTON OH
44721-2430
US

IV. Provider business mailing address

701 S CAPITAL OF TEXAS HWY STE D420
WEST LAKE HILLS TX
78746-5986
US

V. Phone/Fax

Practice location:
  • Phone: 737-703-8191
  • Fax:
Mailing address:
  • Phone: 737-703-8191
  • Fax: 512-243-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL SEESTADT
Title or Position: CEO
Credential:
Phone: 737-703-8191