Organization Active NPI

Wound Specialists of Michigan, P.L.L.C.

  • Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1063592350
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301060835 Issued in MI
Legal business name
WOUND SPECIALISTS OF MICHIGAN, P.L.L.C.
Practice address
2900 Golfside Dr
Suite 4
Ann Arbor, MI 48108-1410
Phone
(866) 645-5578
Fax
(888) 528-0919
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Frank Bongiorno, MD
Title
Owner
Phone
(866) 645-5578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 4301060835 MI Primary

Addresses

Primary practice location

2900 Golfside Dr
Suite 4
Ann Arbor, MI 48108-1410

Mailing address

2900 Golfside Dr
Suite 4
Ann Arbor, MI 48108-1410
Phone (866) 645-5578

Other identifiers 1

IdentifierTypeStateIssuer
4281939MedicaidMI

National Provider Directory

National Provider Directory

Locations

3830 Packard St
Ste 180
Ann Arbor, MI 48108
Phone (734) 354-8850

725 Fuller Ave
Big Rapids, MI 49307
Phone (231) 796-2631

8548 N Canton Center Rd
Canton, MI 48187
Phone (734) 354-8850

366 West St
Cedar Springs, MI 49319
Phone (616) 696-9180

11218 Miller Dr
Galesburg, MI 49053
Phone (269) 665-9529

1480 Walton Blvd
Rochester Hills, MI 48309
Phone (248) 651-4422

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1063592350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 GOLFSIDE DR",
            "address_2": "SUITE 4",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081410",
            "telephone_number": "866-645-5578",
            "fax_number": "888-528-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 GOLFSIDE DR",
            "address_2": "SUITE 4",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081410",
            "telephone_number": "866-645-5578",
            "fax_number": "888-528-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND SPECIALISTS OF MICHIGAN, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "BONGIORNO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-645-5578",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301060835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4281939",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.