Medical school: VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduated: 1989
NPI: 1134113210
Practice Locations (2)
DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
HIGHWAY 191 AND HOSPITAL RD
CHINLE, AZ 865038000
92867470307030
CENTRA MEDICAL GROUP LLC
1901 THOMSON DR
LYNCHBURG, VA 245011026
4342003908
Source: CMS National Downloadable File, September 2026.