Healthcare Provider Details

I. General information

NPI: 1679322002
Provider Name (Legal Business Name): WELLNEST MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1491 E RIDGELINE DR
SOUTH OGDEN UT
84405-4954
US

IV. Provider business mailing address

1887 WHITNEY MESA DR # 9001ZN
HENDERSON NV
89014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 317-790-7550
  • Fax:
Mailing address:
  • Phone: 317-790-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SABA HAQ
Title or Position: PRESIDENT
Credential: MD
Phone: 949-463-0650