Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD012519E | PA |
NPI | 1043423502 |
---|---|
Provider Name | Dr. James William Slavin |
First Address | Elkins Park, PA 19027-2114 |
Second Address | Elkins Park, PA 19027-2114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B36711 | (02) | PA |