MEDICARE: FRONT RANGE ADVANCED WOUND CARE PROFESSIONAL CORPORATION

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1447190590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONT RANGE ADVANCED WOUND CARE PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	15890 LITTLE BLUESTEM RD
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-7512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15890 LITTLE BLUESTEM RD
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-7512
Country	:	US
Telephone Number	:	720-839-0301
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MAXIMILIAN BEKHIT
Credential	:	DO
Telephone Number	:	720-839-0301

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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