| NPI | 1518087287 |
|---|---|
| Doing Business As | PROVIDENCE INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JEREMY W. WHITAKER Manager 803-865-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-03-07 |