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General NPI Number Information
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NPI Number | 1285407767
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Entity Type | Organization
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Legal Business Name | SGA WOUND CENTERS LLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 3815 E BELL RD STE 4300
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City | PHOENIX
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State | AZ
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Zip | 85032-2169
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Country | US
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Telephone | 844-436-7874
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Fax | 877-828-6834
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Provider Business Mailing Address
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Address Line | 29455 N CAVE CREEK RD # 118-451
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City | CAVE CREEK
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State | AZ
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Zip | 85331-3245
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Country | US
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Telephone | 844-436-7874
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Fax | 877-828-6834
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL STUMPF
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Credential | DO
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Telephone | 480-544-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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