| NPI | 1619245222 |
|---|---|
| Other Name | PROVIDENCE HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | BEAU HIGGINBOTHAM Vice President/COO 410-638-3162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2020-02-06 |