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NPI Profile for CENTENNIAL MEDICAL GROUP INC in ROSEBURG, OR.
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Cardiovascular Disease |
207RC0000X | 11 | Physician/Internal Medicine | |
Interventional Cardiology |
207RI0011X | 11 | Physician/Internal Medicine | |
Vascular & Interventional Radiology |
2085R0204X | 94 | Physician/Interventional Radiology |
| NPI # | 1033365135 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/08/2008 | |
| Last updated | 09/22/2020 - About 6 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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CENTENNIAL MEDICAL GROUP INC.