Provider Demographics
NPI:1285889303
Name:AMERICAN WOUND HEALING CENTER INC
Entity type:Organization
Organization Name:AMERICAN WOUND HEALING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-762-0802
Mailing Address - Street 1:10 SCOTCH MIST CT.
Mailing Address - Street 2:STE 111
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2929
Mailing Address - Country:US
Mailing Address - Phone:301-762-0802
Mailing Address - Fax:
Practice Address - Street 1:10 SCOTCH MIST CT
Practice Address - Street 2:STE 111
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2929
Practice Address - Country:US
Practice Address - Phone:301-762-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00334213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6148800001Medicare NSC