| NPI | 1487733929 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP SOUTH |
| Doing Business As | PMG SOUTH CARDIOLOGY |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2025-05-12 |