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General NPI Number Information
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NPI Number | 1417193681
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Entity Type | Organization
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Legal Business Name | WOUND SPECIALISTS OF GREATER CINCINNATI, PLLC
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 10500 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45242-4402
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Country | US
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Telephone | 513-865-1111
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Fax | 513-557-3329
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Provider Business Mailing Address
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Address Line | PO BOX 643911
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City | CINCINNATI
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State | OH
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Zip | 45264-3911
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Country | US
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Telephone | 513-557-3330
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Fax | 513-557-3329
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Authorized Official
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Title or Position | OWNER
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Name | ARTI BALAR MASTURZO
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Credential | MD
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Telephone | 513-557-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35-082412
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 35-082412
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License Number State | OH
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