| NPI | 1447799523 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Secretary For Enrollment 425-525-5392 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2024-10-30 |