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Organization

AUGUSTINE HEALTH GROUP LLC

Active
Other names
Providence Anesthesia Group
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY MOWRER (CREDENTIALING SPECIALIST)
(216) 472-2741
Entity
Organization

Contact information

Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 865-4780
(803) 865-4932
Mailing address
7580 NORTHCLIFF AVE, SUITE 500, BROOKLYN, OH 44144-3270
(855) 477-2477
(216) 472-2740

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Enumeration date
03/29/2014
Last updated
03/29/2014
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