Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN9729 | FL |
NPI | 1801839469 |
---|---|
Provider Name | Dr. Andrew Slavin |
First Address | West Palm Beach, FL 33401-3404 |
Second Address | West Palm Beach, FL 33401-3404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 07/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
072471800 | (05) | FL |
T86317 | (02) | FL |