Organization Active NPI

Wound Pros Michigan

  • General Practice Physician
  • Detroit, MI
National Provider Identifier
1851915623
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WOUND PROS MICHIGAN
Practice address
7633 E Jefferson Ave Ste 110
Detroit, MI 48214-3730
Phone
(323) 545-4035
NPI assigned
Jun 8, 2020
Last updated
Jan 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Dr. Christopher Otiko, DPMNPI 1346223997
Title
President
Phone
(818) 836-2475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

7633 E Jefferson Ave Ste 110
Detroit, MI 48214-3730

Mailing address

5901 W Century Blvd Ste 750
Los Angeles, CA 90045-5443
Phone (323) 480-4075

Other practice location 1

400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502
Phone (818) 836-2475

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1851915623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W CENTURY BLVD STE 750",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455443",
            "telephone_number": "323-480-4075",
            "fax_number": "323-433-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE STE 110",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143730",
            "telephone_number": "323-545-4035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Renaissance Ctr Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482431502",
            "country_code": "US",
            "telephone_number": "818-836-2475",
            "fax_number": "323-433-9177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WOUND PROS MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-836-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.