Organization
MEDWELL MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY ELKASSIS (OWNER)
(810) 813-5550
Entity
Organization
Contact information
Practice address
995 E BASELINE RD APT 2116, TEMPE, AZ 85283-1363
(810) 813-5550
Mailing address
6036 JENNIFER CRES, W BLOOMFIELD, MI 48324-3127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
11/02/2024
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