Provider Demographics
NPI:1447905005
Name:DUPERON WOUND LLC
Entity type:Organization
Organization Name:DUPERON WOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, WOUND CARE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ABUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-996-3269
Mailing Address - Street 1:4345 WINTERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8672
Mailing Address - Country:US
Mailing Address - Phone:989-996-3269
Mailing Address - Fax:
Practice Address - Street 1:33875 KIELY DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-3604
Practice Address - Country:US
Practice Address - Phone:989-996-3269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-12
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty