Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | C10007402 | DE |
Y | 2080P0203X | Pediatric Critical Care Doctor | C10009607 | DE |
N | 2080P0203X | Pediatric Critical Care Doctor | ME98753 | FL |
NPI | 1114046166 |
---|---|
Provider Name | Nicholas B Slamon |
First Address | Rockland, DE 19723-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278644300 | (05) | FL |