1275592891 NPI number — ROBERT I SLAYTON MD

Table of content: ROBERT I SLAYTON MD (NPI 1275592891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275592891 NPI number — ROBERT I SLAYTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLAYTON
Provider First Name:
ROBERT
Provider Middle Name:
I
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275592891
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 PENN AVE
Provider Second Line Business Mailing Address:
SUITE 2100
Provider Business Mailing Address City Name:
WILKINSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15221-2148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-371-1775
Provider Business Mailing Address Fax Number:
412-371-3904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 PENN AVE
Provider Second Line Business Practice Location Address:
SUITE 2100
Provider Business Practice Location Address City Name:
WILKINSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-371-1775
Provider Business Practice Location Address Fax Number:
412-371-3904
Provider Enumeration Date:
03/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  MD022354E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00087035900002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 260003373 . This is a "UNITED HEALTH CARE MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110928 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251719945 . This is a "TRI CARE NORTH REGION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 260003373 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000110328 . This is a "HIGHMARK BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205489 . This is a "UPMC HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 087035901 . This is a "GREENSPRING OF WEST PA" identifier . This identifiers is of the category "OTHER".




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