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NPI Code Detail

MEDICARE: HEALTHWELL MEDICAL GROUP

MEDICARE: HEALTHWELL MEDICAL GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician10005NV
2208000000XPediatrics Physician10006NV

General Provider Information

NPI Number : 1972669661
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHWELL MEDICAL GROUP
Provider Business Mailing Address
First Line : PO BOX 82277
Second Line :
City : LAS VEGAS
State : NV
Zip : 89180
Country : US
Telephone Number : 702-894-9422
Fax Number : 702-894-9258
Provider Business Practice Location Address
First Line : 4375 S BUFFALO DR
Second Line : #101
City : LAS VEGAS
State : NV
Zip : 89147
Country : US
Telephone Number : 702-894-9422
Fax Number : 702-894-9258
Authorized Official
Title or Position : DOCTOR OFFICE MANAGER
Name : DR. GRACE CANO DEBELEN
Credential : MD
Telephone Number : 702-894-9422
Provider Enumeration Date : 12/28/2006
Last Update Date : 09/11/2025

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Directions to “HEALTHWELL MEDICAL GROUP ” Practice Location

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