| NPI | 1124029715 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | SETH K. ADJOVU President/Owner 702-798-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 10335) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 10335) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2020-08-22 |