| NPI | 1093956278 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP ALASKA |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Asst Sec Enrollmt/Dir Reimb Admin 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2024-03-07 |