Organization
CENTENNIAL MEDICAL GROUP INC.
Active
Other names
Centennial Shaw Heart & Vascular Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
ARIC GROSHONG MD (MEDICAL DIRECTOR)
(541) 677-4319
Entity
Organization
Contact information
Practice address
2801 NW MERCY DR STE 300, ROSEBURG, OR 97471-2348
(541) 677-1555
(541) 677-1554
Mailing address
201 NW MEDICAL LOOP STE 190, ROSEBURG, OR 97471-8835
(541) 677-4319
(541) 677-2294
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
141133
OR
207RI0011X
Interventional Cardiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
08/08/2008
Last updated
09/22/2020
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