| NPI | 1174969778 |
|---|---|
| Doing Business As | PMG ASHLAND |
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2025-05-12 |