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CENTERWELL SENIOR PRIMARY CARE GA PC NPI 1013672815


NPI Information

NPI: 1013672815
Provider Name: CENTERWELL SENIOR PRIMARY CARE GA PC

Doing Business As: CENTERWELL SENIOR PRIMARY CARE- GROVE PARK

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D2261240

Address:
2056 DONALD LEE HOLLOWELL PKWY NW STE 1
ATLANTA, GA
ZIP 30318
Phone: (470) 890-3910
Get Directions

CENTERWELL SENIOR PRIMARY CARE GA PC is an internal medicine in Atlanta, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. CENTERWELL SENIOR PRIMARY CARE GA PC NPI is 1013672815. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centerwell Senior Primary Care- Grove Park.

The provider's business location address is:

2056 DONALD LEE HOLLOWELL PKWY NW STE 1
ATLANTA, GA
ZIP 30318-764
Phone: (470) 890-3910
Fax: (877) 445-5270

The provider's authorized official is Angie Martinez .
The authorized official title is Senior Credentialing Professional and has the following contact phone number (407) 447-7120.

The CLIA number assigned to this NPI record is 11D2261240 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/5/2021 and was last updated on 10/14/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2208D00000XGeneral PracticeNo
3207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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