MEDICARE: NEXGEN WOUND CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1063385292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXGEN WOUND CARE PLLC

Provider Business Mailing Address
First Line	:	12288 PENINSULA DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-9245
Country	:	US
Telephone Number	:	231-649-2672
Fax Number	:

Provider Business Practice Location Address
First Line	:	12288 PENINSULA DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-9245
Country	:	US
Telephone Number	:	231-649-2672
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COLIN SEGUIN
Credential	:	DO
Telephone Number	:	231-649-2672

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	03/08/2026

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