Centerwell Senior Primary Care Va Pllc

NPI #1144920497 in Hampton, Virginia

Provider Information

NPI Number: 1144920497
Entity Type: Organization
Organization Name: Centerwell Senior Primary Care Va Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: CENTERWELL SENIOR PRIMARY CARE VA PLCC
Primary Specialty: Internal Medicine
Enumeration Date: Mar 6, 2023
Last Updated: Aug 19, 2024

Practice Location

Address: 1118 W MERCURY BLVD
City: Hampton
State: Virginia
ZIP Code: 23666-3328
Phone: (757) 276-9526

Authorized Official

Name: ANGIE MARTINEZ
Title: SENIR CREDENTIALING PROFESSIONAL
Phone: (407) 447-7120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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