Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Centennial Medical Group, PA

Organization Family Medicine Physician · NPI 1093584930

Centennial Medical Group, PA is a Family Medicine Physician in Burtonsville, Maryland. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15646 Old Columbia Pike
Burtonsville, MD 20866-1630
Phone: (410) 730-3399
Fax: (443) 478-4747
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1093584930
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rajiv Dua — Medical Director · (410) 730-3399
NPI enumeratedDecember 20, 2023
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024
Mailing address6230 Old Dobbin Ln, Columbia, MD 21045-5803

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