MEDICARE: CANTERBURY HOUSE DIRECT PRIMARY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1700715240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANTERBURY HOUSE DIRECT PRIMARY CARE

Provider Business Mailing Address
First Line	:	8500 STATION ST STE 270
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4943
Country	:	US
Telephone Number	:	440-641-4146
Fax Number	:	440-596-4633

Provider Business Practice Location Address
First Line	:	8500 STATION ST STE 270
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4943
Country	:	US
Telephone Number	:	440-641-4146
Fax Number	:	440-596-4633

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH WATSON
Credential	:	DO
Telephone Number	:	440-641-4146

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “CANTERBURY HOUSE DIRECT PRIMARY CARE ” Practice Location

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