| NPI | 1730802364 |
|---|---|
| Doing Business As | PMG MT PEDIATRICS |
| Doing Business As | PROVIDENCE MEDICAL GROUP MONTANA |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2025-05-07 |