| NPI | 1427281203 |
|---|---|
| Doing Business As | PMG MT BROADWAY INTERNAL MED |
| Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollments 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2025-05-06 |