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NPI Code Detail

MEDICARE: DR. CHARLES E SLONAKER MD

MEDICARE: DR. CHARLES E SLONAKER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician10103MS

General Provider Information

NPI Number : 1235122268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES E SLONAKER MD
Provider Business Mailing Address
First Line : PO BOX 1569
Second Line :
City : GULFPORT
State : MS
Zip : 39502-1569
Country : US
Telephone Number : 228-832-9924
Fax Number :
Provider Business Practice Location Address
First Line : 4500 13TH ST
Second Line :
City : GULFPORT
State : MS
Zip : 39501-2515
Country : US
Telephone Number : 228-575-2327
Fax Number : 228-575-2380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 10/25/2007

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Directions to “ DR. CHARLES E SLONAKER MD” Practice Location

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