Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Centerwell Senior Primary Care Ga PC

Organization Family Medicine Physician · NPI 1366269367

Centerwell Senior Primary Care Ga PC is a Family Medicine Physician in Dallas, Georgia. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3615 Charles Hardy Pkwy # 200
Dallas, GA 30157-9472
Phone: (678) 941-6247
Fax: (678) 293-9610
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1366269367
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care Ga PC
Authorized official Angie Martinez — Senior Credentialing Professional · (407) 447-7120
Other names Centerwell Senior Primary Care-East Paulding; Centerwell Senior Primary Care-East Paulding
NPI enumeratedSeptember 23, 2024
Last updated in NPPESDecember 17, 2024
Certification dateDecember 17, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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