MEDICARE: LAWRENCE EDWARD SLAMA 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	207RP1001X	Pulmonary Disease Physician	13658	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	290010133	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578553855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE EDWARD SLAMA M.D.

Provider Business Mailing Address
First Line	:	3330 N 2ND ST
Second Line	:	SUITE 300
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2368
Country	:	US
Telephone Number	:	602-261-7830
Fax Number	:	602-261-7835

Provider Business Practice Location Address
First Line	:	9700 N 91ST ST
Second Line	:	SUITE A200
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5054
Country	:	US
Telephone Number	:	480-614-2000
Fax Number	:	480-614-1751

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/08/2011

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Directions to “ LAWRENCE EDWARD SLAMA M.D.” Practice Location

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