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General NPI Number Information
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NPI Number | 1487520789
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Entity Type | Organization
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Legal Business Name | ELITE WOUND EXPERTS
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 01/18/2026
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Provider Practice Location Address
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Address Line | 5924 BRAMALEA AVE SE
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City | KENTWOOD
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State | MI
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Zip | 49508-6421
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Country | US
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Telephone | 616-616-5987
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Fax | 616-616-6044
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Provider Business Mailing Address
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Address Line | 5924 BRAMALEA AVE SE
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City | KENTWOOD
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State | MI
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Zip | 49508-6421
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Country | US
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Telephone | 616-616-5987
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Fax | 616-616-6044
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | SHAWNA MILLER
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Credential |
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Telephone | 616-226-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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