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Organization
CENTRA MEDICAL GROUP, LLC
Active
Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Piedmont Primecare-Centra Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
LEWIS ADDISON (CFO)
(434) 200-3656
Entity
Organization
Contact information
Practice address
404 AIRPORT DR, SUITE A, DANVILLE, VA 24540-5196
(434) 791-2612
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/15/2011
Last updated
11/14/2012
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