Organization · Type 2 NPI

Centerwell Senior Primary Care Ga PC

Internal Medicine Physician · Stone Mountain, GA

NPI number 1760059331 Active

Practice location

5244 Memorial Drive, Suite 1101
Stone Mountain, GA 30083-3157

Call (404) 905-0100 Map

Fax (877) 890-2406

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician Primary	207R00000X	None listed
General Practice Physician	208D00000X	None listed

Internal Medicine Physician: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medi…

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NPI record

NPI: 1760059331
Entity type: Organization (Type 2)
Issued: Jun 10, 2021
Last updated: Aug 24, 2026
Status: Active
Subpart: Yes of Centerwell Senior Primary Care Ga PC

Other names

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Centerwell Senior Primary Care-Stone Mountain · doing business as
Centerwell Senior Primary Care-Stone Mountain · doing business as

Authorized official

Angie Martinez
Credentialing Supervisor
(407) 447-7120

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About NPI 1760059331

Centerwell Senior Primary Care Ga PC's National Provider Identifier is 1760059331, issued on Jun 10, 2021. The primary taxonomy on file is Internal Medicine Physician (207R00000X), and the practice location is in Stone Mountain, GA. The record was last updated on Aug 24, 2026.