Organization
CENTRA MEDICAL GROUP BEDFORD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS ADDISON (SR VP CFO)
(434) 200-5047
Entity
Organization
Contact information
Practice address
1613 OAKWOOD ST, BEDFORD, VA 24523-1213
(434) 200-3656
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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