Organization
VM PROVISION CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ATIF MIAN MD (CEO)
(253) 651-2498
Entity
Organization
Contact information
Practice address
3640 S CEDAR ST STE O, TACOMA, WA 98409-5700
(253) 651-2498
Mailing address
PO BOX 64375, TACOMA, WA 98464-0375
(253) 651-2498
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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