| NPI | 1144523051 |
|---|---|
| Doing Business As | PROVIDENCE INTERNAL MEDICINE NORTHEAST |
| Entity Type | Organization |
| Authorized Contact | ANGELA HAITHCOCK Project Manager 803-865-4780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2012-02-06 |