=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811818891
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINGATE WOUND CARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2026
-----------------------------------------------------
Last Update Date | 07/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22720 WOODWARD AVE STE 207
-----------------------------------------------------
City | FERNDALE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48220-2906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-396-7612
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1221 BOWERS ST UNIT 2710
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48012-7106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-396-7612
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEFFREY WINGATE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 248-396-7612
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207XS0117X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery of the Spine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------