Centennial Medical Group, PA

NPI #1306477849 in Gambrills, Maryland

Provider Information

NPI Number: 1306477849
Entity Type: Organization
Organization Name: Centennial Medical Group, PA
Subpart: Yes (part of a larger organization)
Parent Organization: CENTENNIAL MEDICAL GROUP
Primary Specialty: General Practice
Enumeration Date: Feb 3, 2020
Last Updated: Feb 3, 2020

Practice Location

Address: 1071 MD RT 3 N STE 101
City: Gambrills
State: Maryland
ZIP Code: 21054-1784
Phone: (410) 721-2333

Authorized Official

Name: RON ELFENBEIN, MD
Title: MEDICAL DIRECTOR
Phone: (410) 721-2333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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