Centerwell Senior Primary Care (mo) PC

NPI #1649793001 in Independence, Missouri

Provider Information

NPI Number: 1649793001
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: Internal Medicine
Enumeration Date: Jul 18, 2017
Last Updated: Jan 24, 2025

Practice Location

Address: 19401 E 39TH ST S
City: Independence
State: Missouri
ZIP Code: 64057-2308
Phone: (816) 490-4277

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
General Practice	208D00000X
Non-Pharmacy Dispensing Site	332900000X
Internal Medicine	207R00000X	Primary

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