| Organization Name: | SENTARA MEDICAL GROUP |
| NPI Number: | 1104043264 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CINDY A TAYLOR (MANAGER) |
| Mailing Address: | 534 Caratoke Hwy Moyock |
| State: | NC US |
| Postal Code: | 279588740 |
| Phone Number: | 2524356621 |
| Fax Number: | 2524352685 |
| NPI Enumeration Date: | 04/19/2007 |
| NPI Last Update Date: | 09/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |