Provider Demographics
NPI:1437566791
Name:WOUND CARE & HYPERBARIC MEDICINE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WOUND CARE & HYPERBARIC MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CETARUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-765-3800
Mailing Address - Street 1:2555 S DOWNING ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2555 S DOWNING ST
Practice Address - Street 2:SUITE 260
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5855
Practice Address - Country:US
Practice Address - Phone:303-765-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDWARD W. CETARUK, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34578207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty