| Organization Name: | CENTRA HEALTH PROFESSIONAL SERVICES, LLC |
| NPI Number: | 1114951340 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAMMY TWEEDY (DIRECTOR) |
| Mailing Address: | 1084 Thomas Jefferson Rd Suite 10 Forest |
| State: | VA US |
| Postal Code: | 245512275 |
| Phone Number: | 4344550626 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 03/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RP1001X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Pulmonary Disease |
| Taxonomy Definition: | An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |