| NPI | 1588981963 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE ST VINCENT HEART CLINICS CARDIOLOGY BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2025-06-20 |