Providence Medical Group
NPI #1760658371 in Moraine, Ohio
Provider Information
- NPI Number
- 1760658371
- Entity Type
- Organization
- Organization Name
- Providence Medical Group
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PROVIDENCE MEDICAL GROUP
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- May 3, 2008
- Last Updated
- Nov 26, 2014
Practice Location
Authorized Official
- Name
- SHIRLEY A PFEIFFER
- Title
- CREDENTIALING COORDINATOR
- Phone
- (937) 297-8999
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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