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General NPI Number Information
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NPI Number | 1821690199
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Entity Type | Organization
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Legal Business Name | CENTRA MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 3300 RIVERMONT AVE
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City | LYNCHBURG
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State | VA
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Zip | 24503-2030
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Country | US
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Telephone | 434-200-5933
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Fax | 434-200-4553
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Provider Business Mailing Address
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Address Line | 1937 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR REVENUE CYCLE
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Name | SONYA R T DAVIS
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Credential |
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Telephone | 434-200-6942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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