Provider Demographics
NPI:1316628738
Name:HEAL DIABETES INC
Entity type:Organization
Organization Name:HEAL DIABETES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:DESGRAVES
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:972-743-3935
Mailing Address - Street 1:1360 S BERETANIA ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1520
Mailing Address - Country:US
Mailing Address - Phone:808-210-4444
Mailing Address - Fax:808-210-5505
Practice Address - Street 1:1360 S BERETANIA ST STE 500
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1520
Practice Address - Country:US
Practice Address - Phone:808-210-4444
Practice Address - Fax:808-210-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty