Organization
IMAGINE PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH PODKOWA JR. DO (MEDICAL DIRECTOR)
(774) 264-0932
Entity
Organization
Contact information
Practice address
370 FAUNCE CORNER RD STE 103, DARTMOUTH, MA 02747-1271
(774) 264-0932
Mailing address
4 BRIGGS LANE CT, MARION, MA 02738-1681
(774) 264-0932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285621300
NPI
MA
01
—
1457808024
NPI
MA
01
—
1750361713
NPI
MA
01
—
1932373552
NPI
MA
Enumeration date
11/15/2021
Last updated
11/15/2021
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