NPI 1003528092

Centerwell Senior Primary Care Ms PC

Organisation Internal Medicine Physician Gulfport, MS

Practice location

Address: 12057 Highway 49 STE C, Gulfport, MS 39503-3177
Phone: (228) 832-9385
Fax: (877) 504-6444
Mailing address: 6101 Blue Lagoon Dr STE 200, Miami, FL 33126-3168

Authorised official

Name: Angie Martinez
Title: Senior Credentialing Professional
Phone: (407) 447-7120

Registered specialties (3)

Internal Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207R00000X

Other Internal Medicine providers in Mississippi →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Mississippi →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Mississippi →

Registry record

NPI: 1003528092
Entity type: Organization
NPI issued: 21 Dec 2022
Record last updated: 3 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.