| NPI | 1811717333 |
|---|---|
| Doing Business As | CENTERWELL SENIOR PRIMARY CARE (SC) JV PC - FAIRWOLD |
| Entity Type | Organization |
| Authorized Contact | MEGAN GALVAN Credentialing Manager 305-500-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |