Organization
CENTERWELL SENIOR PRIMARY CARE GA PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE GA PC
Other names
CenterWell Senior Primary Care-West Augusta
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE GA PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
3435 WRIGHTSBORO RD STE 1202, AUGUSTA, GA 30909-2519
(706) 445-2349
(678) 293-9581
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(407) 447-7120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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