| NPI | 1790196293 |
|---|---|
| Other Name | PROVIDENCE CARDIOLOGY |
| Entity Type | Organization |
| Authorized Contact | LARRY R ELLIS CEO 803-254-3278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2014-05-19 |