NPI | 1033741616 |
---|---|
Doing Business As | CENTERWELL SENIOR PRIMARY CARE- TIDWELL |
Doing Business As | PARTNERS IN PRIMARY CARE-TIDWELL |
Former Legal Business Name | PARTNERS IN PRIMARY CARE KS, PA |
Former Legal Business Name | PARTNERS IN PRIMARY CARE TX, PA |
Entity Type | Organization |
Authorized Contact | ANGIE MARTINEZ Senior Credentialing Professional 407-447-7120 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
208D00000X General Practice | |
Enumeration Date | 2020-02-11 |
Last Update Date | 2022-10-18 |