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General NPI Number Information
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NPI Number | 1740165679
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Entity Type | Organization
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Legal Business Name | MS WOUND CARE PC
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2247 E MALLORY CIR
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City | MESA
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State | AZ
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Zip | 85213-1413
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Country | US
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Telephone | 949-627-3272
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Fax | 949-499-9877
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Provider Business Mailing Address
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Address Line | 19 CHAPITAL
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-9311
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Country | US
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Telephone | 949-627-3272
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Fax | 949-499-9877
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Authorized Official
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Title or Position | OWNER
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Name | MARCUS YETTER
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Credential | DPM
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Telephone | 480-390-8436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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