Organization
IMAGINE PRIMARY CARE, PC
Active
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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