| NPI | 1235370065 | 
|---|---|
| Doing Business As | PMG MT WOUND CARE | 
| Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA | 
| Entity Type | Organization | 
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollments 425-358-9786  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | 
| Enumeration Date | 2009-03-06 | 
| Last Update Date | 2025-05-06 |