Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 26448 | MO |
NPI | 1780694877 |
---|---|
Provider Name | Raymond G Slavin |
First Address | St Louis, MO 63110 |
Second Address | Saint Louis, MO 63110-2540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 17/03/2008 |