NPI | 1366748550 |
---|---|
Doing Business As | PROVIDENCE MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | DONALD WAYNE ANDERSON Director Reimb Regulatory Strategy 425-525-5392 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2011-02-04 |
Last Update Date | 2024-02-02 |