Organization · Type 2 NPI

Centra Medical Group, LLC

Vascular Surgery Physician · Lynchburg, VA

NPI number 1386825040 Active

Practice location

1911 Thomson Dr
Lynchburg, VA 24501-1008

Call (434) 200-3901 Map

Mailing address

2010 Atherholt Rd
Lynchburg, VA 24501-1106

Specialties and licenses

Taxonomy	Code	License
Vascular Surgery Physician Primary	2086S0129X	None listed

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

6 other providers at this address

Other vascular surgery physician providers in Lynchburg

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NPI record

NPI: 1386825040
Entity type: Organization (Type 2)
Issued: Nov 21, 2007
Last updated: Oct 16, 2014
Status: Active
Subpart: Yes of Centra Medical Group, LLC

Other names

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Centra Medical Group Surgical Specialists · doing business as

Authorized official

Lewis Addison
Director
(434) 200-5047

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386825040

Centra Medical Group, LLC's National Provider Identifier is 1386825040, issued on Nov 21, 2007. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Lynchburg, VA. The record was last updated on Oct 16, 2014.