Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
CMG Pediatric Endocrinology Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
SONYA R T DAVIS (DIRECTOR REVENUE CYCLE)
(434) 200-6942
Entity
Organization
Contact information
Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-5933
(434) 200-4553
Mailing address
1937 THOMSON DR, LYNCHBURG, VA 24501-1008
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/20/2020
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