# CENTRA MEDICAL GROUP ENDOCRINOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRA MEDICAL GROUP, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306453675
- **Legal business name:** CENTRA MEDICAL GROUP, LLC
- **Authorized official:** SONYA R T DAVIS (DIRECTOR)
- **Authorized official phone:** (434) 200-6942

## Contact information

- **Practice address:** 125 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
- **Practice address phone:** (434) 200-4422
- **Mailing address:** 1937 THOMSON DR, LYNCHBURG, VA 24501-1008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2020
- **Last updated:** 09/30/2020