| NPI | 1205188893 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP INFECTIOUS DISEASE CONSULTANTS EAST |
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2025-07-04 |