Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 30014550 | OH |
Y | 213EG0000X | General Practice | 30014550 | OH |
NPI | 1003937087 |
---|---|
Provider Name | Dr. Richard P. Slaten |
First Address | Chagrin Falls, OH 44023-4595 |
Second Address | Chagrin Falls, OH 44023-4595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 09/02/2010 |