| NPI | 1427096585 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GOUP MONTANA |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: N/A) |
| 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: N/A) | |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 363AM0700X Physician Assistant Medical (Licence: N/A) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-09-16 |