Organization
CENTENNIAL MEDICAL GROUP, PA
Active
Parent organization
CENTENNIAL MEDICAL GROUP
Other names
Centennial Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTENNIAL MEDICAL GROUP
Authorized official
RON ELFENBEIN MD (MEDICAL DIRECTOR)
(410) 721-2333
Entity
Organization
Contact information
Practice address
1071 MD RT 3 N STE 101, GAMBRILLS, MD 21054-1784
(410) 721-2333
Mailing address
5005 SIGNAL BELL LN STE 200, CLARKSVILLE, MD 21029-2608
(410) 730-3399
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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