Provider Demographics
NPI:1992419287
Name:CENTRA MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:CENTRA MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR PFS
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-200-6942
Mailing Address - Street 1:115 AMBRIAR PLZ
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:VA
Mailing Address - Zip Code:24521-4741
Mailing Address - Country:US
Mailing Address - Phone:434-946-9565
Mailing Address - Fax:
Practice Address - Street 1:115 AMBRIAR PLZ
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:VA
Practice Address - Zip Code:24521-4741
Practice Address - Country:US
Practice Address - Phone:434-946-9565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRA MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty