| NPI | 1043474497 |
|---|---|
| Other Name | PROVIDENCE HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | BEAU HIGGINBOTHAM Vice President/COO 410-368-3162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC HFD01-0212) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2017-10-10 |