MEDICARE: DR. FREDERICK A SLEZAK M.D.

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
1	174400000X	Specialist	35042503S	OH
2	208C00000X	Colon & Rectal Surgery Physician	35042503	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000029353	OTHER	OH	ANTHEM BC BS

General Provider Information

NPI Number	:	1508862483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK A SLEZAK M.D.

Provider Business Mailing Address
First Line	:	699 PINE POINT DR
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-1780
Country	:	US
Telephone Number	:	330-730-3396
Fax Number	:

Provider Business Practice Location Address
First Line	:	699 PINE POINT DR
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-1780
Country	:	US
Telephone Number	:	330-730-3396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	04/12/2020

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