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Organization
CENTENNIAL MEDICAL GROUP
Active
Organization
CENTENNIAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIA YOUNG (CREDENTIALING MANAGER)
(410) 730-3399
Entity
Organization
Contact information
Practice address
10981 JOHNS HOPKINS RD, LAUREL, MD 20723-6002
(410) 730-3399
(443) 478-4737
Mailing address
6230 OLD DOBBIN LN STE 230, COLUMBIA, MD 21045-5884
(410) 730-3399
(443) 478-4737
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/28/2025
Last updated
02/28/2025
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