| Organization Name: | CENTENNIAL MEDICAL GROUP, INC. |
| NPI Number: | 1033365135 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAHUL S. AGARWAL (CORP SECRETARY) |
| Mailing Address: | 2801 Nw Mercy Dr Suite 300 Roseburg |
| State: | OR US |
| Postal Code: | 974712348 |
| Phone Number: | 5416771555 |
| Fax Number: | 5416771554 |
| NPI Enumeration Date: | 08/08/2008 |
| NPI Last Update Date: | 01/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RI0011X |
| License Number: | 141133 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Interventional Cardiology |
| Taxonomy Definition: | An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |