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 1760059331

Centerwell Senior Primary Care Ga PC is a Family Medicine Physician in Stone Mountain, Georgia. Registered with an NPI since 2021.

In the registry since
2021
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

5244 Memorial Dr Ste 1101
Stone Mountain, GA 30083-3157
Phone: (404) 905-0100
Fax: (877) 890-2406
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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 number1760059331
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCenterwell Senior Primary Care Ga PC
Authorized official Angie Martinez — Credentialing Supervisor · (407) 447-7120
Other names Centerwell Senior Primary Care-Stone Mountain; Centerwell Senior Primary Care-Stone Mountain
NPI enumeratedJune 10, 2021
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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