| NPI | 1871887919 |
|---|---|
| Doing Business As | PROVIDENCE INTERNAL MEDICINE DOWNTOWN |
| Entity Type | Organization |
| Authorized Contact | ANGELA HAITHCOCK Credetialing Coordinator 803-865-4780 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 1376) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |