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CENTERWELL SENIOR PRIMARY CARE GA PC NPI 1043887698


NPI Information

NPI: 1043887698
Provider Name: CENTERWELL SENIOR PRIMARY CARE GA PC

Doing Business As: CENTERWELL SENIOR PRIMARY CARE-ADAMSVILLE

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D2243692

Address:
3571 MARTIN LUTHER KING JR DR SW
ATLANTA, GA
ZIP 30331
Phone: (470) 832-6550
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 1043887698. 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-adamsville.

The provider's business location address is:

3571 MARTIN LUTHER KING JR DR SW
ATLANTA, GA
ZIP 30331-017
Phone: (470) 832-6550
Fax: (877) 887-6103

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

The CLIA number assigned to this NPI record is 11D2243692 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2021 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.