NPI 1518103274
Centennial Medical Group INC.
Practice location
- Address
- 201 NW Medical Loop STE 190, Roseburg, OR 97471-8835
- Phone
- (541) 644-4319
- Fax
- (541) 677-2294
Authorised official
- Name
- Donna Raylene van Dis
- Title
- Credentialing Coordinator
- Phone
- (541) 677-4319
Registered specialties (8)
Surgery Physician
Primary
Cardiovascular Disease Physician
Gastroenterology Physician
Pulmonary Disease Physician
Sleep Medicine (Internal Medicine) Physician
Clinical Pathology/Laboratory Medicine Physician
Urology Physician
Hospitalist Physician
Registry record
- NPI
- 1518103274
- Entity type
- Organization
- NPI issued
- 31 Dec 2008
- Record last updated
- 25 Nov 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.