OrganizationActive
Centennial Medical Group, PA
NPI 1093584930 · Family Medicine Physician · Burtonsville, MD
Provider details
- NPI number
- 1093584930
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Rajiv Dua, Medical Director(410) 730-3399
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15646 Old Columbia Pike
Burtonsville, MD 20866-1630
Phone: (410) 730-3399
Fax: (443) 478-4747
Street-level locationGet directions
Mailing address
6230 Old Dobbin Ln
Columbia, MD 21045-5803
Registry dates
- Enumerated
- 2023-12-20
- Last updated
- 2024-09-18
- Certified
- 2024-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.