Provider Demographics
NPI:1346534765
Name:NUWELL MEDICAL GROUP INC
Entity Type:Organization
Organization Name:NUWELL MEDICAL GROUP INC
Other - Org Name:NUWELL HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DONATUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUANAEGBULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-680-2239
Mailing Address - Street 1:315 N TRAVIS ST
Mailing Address - Street 2:SUITE C5
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-0028
Mailing Address - Country:US
Mailing Address - Phone:214-680-2239
Mailing Address - Fax:214-717-4162
Practice Address - Street 1:315 N TRAVIS ST
Practice Address - Street 2:SUITE C5
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-0028
Practice Address - Country:US
Practice Address - Phone:214-680-2239
Practice Address - Fax:214-717-4162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX014317251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health