Organization
CENTENNIAL MEDICAL GROUP WEST, LLC
Active
Parent organization
CENTENNIAL MEDICAL GROUP, INC.
Other names
Gerald Engstrom, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTENNIAL MEDICAL GROUP, INC.
Authorized official
RAHUL AGARWAL (PRESIDENT)
(541) 677-2494
Entity
Organization
Contact information
Practice address
2801 NW MERCY DR, SUITE 345, ROSEBURG, OR 97471-2348
(541) 677-2494
(541) 677-2294
Mailing address
2801 NW MERCY DR, SUITE 340, ROSEBURG, OR 97471-2348
(541) 677-2494
(541) 677-2294
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD15315
OR
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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