Centerwell Senior Primary Care (mo) PC

NPI #1538712724 in Grandview, Missouri

Provider Information

NPI Number: 1538712724
Entity Type: Organization
Organization Name: Centerwell Senior Primary Care (mo) PC
Subpart: Yes (part of a larger organization)
Parent Organization: CENTERWELL SENIOR PRIMARY CARE (MO) PC
Primary Specialty: Family Medicine
Enumeration Date: Jul 17, 2019
Last Updated: Aug 19, 2024

Practice Location

Address: 1513 MAIN ST
City: Grandview
State: Missouri
ZIP Code: 64030-2515
Phone: (816) 731-1890

Authorized Official

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

Specialties & Taxonomy Codes

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

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