Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 71602 | MA |
NPI | 1871530980 |
---|---|
Provider Name | Dr. Mark Paul Slovenkai |
First Address | Waltham, MA 02451-1433 |
Second Address | Waltham, MA 02451-1433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 20/01/2017 |