Organization
PROVIDENCE GROUP PRACTICES II, LLC
Active
Organization
PROVIDENCE GROUP PRACTICES II, LLC
Active
Other names
Providence Cardiovascular Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
1330 HAILE ST, CAMDEN, SC 29020-3002
(803) 434-6771
(803) 424-1900
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
16159207780
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/21/2017
Last updated
09/25/2017
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