# MY WELLNESS WATCH PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770456584
- **Authorized official:** MAZEN ISSA MADHOUN MD (OWNER)
- **Authorized official phone:** (540) 397-5319

## Contact information

- **Practice address:** 6002 WINNBROOK LN, ROANOKE, VA 24018-7907
- **Practice address phone:** (540) 397-5319
- **Practice address fax:** (540) 900-0991
- **Mailing address:** 6002 WINNBROOK LN, ROANOKE, VA 24018-7907
- **Mailing address phone:** (540) 397-5319
- **Mailing address fax:** (540) 900-0991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2025
- **Last updated:** 09/26/2025