| NPI | 1568541894 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE MEDICAL GROUP INFECTIOUS DISEASE CONSULTANTS |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Assistant Secretary Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2024-06-13 |