Residential Professional Wound Care Specialists PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RESIDENTIAL PROFESSIONAL WOUND CARE SPECIALISTS PLLC

Practice address

20927 Kelly Rd Ste 1
Eastpointe, MI 48021-3128

Phone

(313) 733-8286

Fax

(313) 826-0899

NPI assigned

Jan 18, 2022

Organization subpart

No

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

Authorized official

Name

Ribhi Hazin, MD

Title

Owner

Phone

(313) 733-8286

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1144971482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 CARPENTER ST STE 5",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482122784",
            "telephone_number": "313-733-8286",
            "fax_number": "313-826-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20927 KELLY RD STE 1",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213128",
            "telephone_number": "313-733-8286",
            "fax_number": "313-826-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL PROFESSIONAL WOUND CARE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "HAZIN",
        "authorized_official_first_name": "RIBHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-733-8286",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.