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Contact Information

CENTERWELL SENIOR PRIMARY CARE GA PC
6085 OLD NATIONAL HWY STE G
SOUTH FULTON, GA30349-4333
 Phone: 470-754-6360
 Fax: 877-780-7359
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for CENTERWELL SENIOR PRIMARY CARE GA PC

NPI Number 1801463468
LBN Legal business name CENTERWELL SENIOR PRIMARY CARE GA PC
Authorized official ANGIE MARTINEZ - (SENIOR CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/10/2021
Last updated 07/03/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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