Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 085003616 | IL |
NPI | 1063749141 |
---|---|
Provider Name | Mrs. Megan R Slocum |
First Address | Baltimore, MD 21297-3174 |
Second Address | Fairfax, VA 22031-4867 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2009 |
Last Update Date | 22/12/2021 |