Healthcare Provider Details

I. General information

NPI: 1811303811
Provider Name (Legal Business Name): CINCINNATI ADVANCED WOUND CARE PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11497 SPRINGFIELD PIKE STE 5
SPRINGDALE OH
45246-3551
US

IV. Provider business mailing address

11497 SPRINGFIELD PIKE STE 5
SPRINGDALE OH
45246-3551
US

V. Phone/Fax

Practice location:
  • Phone: 513-326-2040
  • Fax: 513-771-0241
Mailing address:
  • Phone: 513-326-2040
  • Fax: 513-771-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WAHEED ADEUMI
Title or Position: OWNER
Credential: MD
Phone: 513-326-2040