| NPI | 1609938471 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP |
| Doing Business As | PROVIDENCE MEDICAL GROUP AT ST VINCENT |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Asst Sec For Enrollment 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-10-02 |