| NPI | 1609446087 |
|---|---|
| Doing Business As | ASCENSION PROVIDENCE DIABETES MANAGEMENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | MIRANDA HEMM Enrollment Manager 904-450-6004 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |