Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD047758L | PA |
NPI | 1003880006 |
---|---|
Provider Name | Dr. Stephen O Slusser |
First Address | Pottsville, PA 17901-3875 |
Second Address | Pottsville, PA 17901-3875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 11/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001468219 | (05) | PA |
F85282 | (02) | PA |