| Centerwell Senior Primary Care- State Avenue | |
|
7527 State Ave Kansas City KS 66112-2815 | |
| (913) 335-6986 | |
| (855) 446-7151 |
| Full Name | Centerwell Senior Primary Care- State Avenue |
|---|---|
| Speciality | Internal Medicine |
| Location | 7527 State Ave, Kansas City, Kansas |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care- State Avenue 4700 Millenia Blvd Ste 650 Orlando FL 32839-6013 Ph: (407) 447-7120 | Centerwell Senior Primary Care- State Avenue 7527 State Ave Kansas City KS 66112-2815 Ph: (913) 335-6986 |
| NPI Number | 1104347756 |
|---|---|
| Provider Enumeration Date | 07/05/2017 |
| Last Update Date | 03/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104347756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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