# PROVIDENCE SURGICAL CARE GROUP, INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437232543
- **Authorized official:** MR. ROBERT B PATTERSON MD (PRESIDENT)
- **Authorized official phone:** (401) 454-0690

## Contact information

- **Practice address:** 486 SILVER SPRING ST, PROVIDENCE, RI 02904-1556
- **Practice address phone:** (401) 454-0690
- **Practice address fax:** (401) 454-4281
- **Mailing address:** 486 SILVER SPRING ST, PROVIDENCE, RI 02904-1556
- **Mailing address phone:** (401) 454-0690
- **Mailing address fax:** (401) 454-4281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 12/23/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PS32025 | — | RI |