MEDICARE: MICHAEL JOSEPH SLOGIC 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
1	208000000X	Pediatrics Physician	57-015275	OH
2	2080P0006X	Developmental - Behavioral Pediatrics Physician	2018011956	MO
3	2080P0006X	Developmental - Behavioral Pediatrics Physician	04-044755	KS

General Provider Information

NPI Number	:	1932352754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH SLOGIC MD

Provider Business Mailing Address
First Line	:	2000 OLATHE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-4619
Country	:	US
Telephone Number	:	913-588-5943
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 OLATHE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8505
Country	:	US
Telephone Number	:	913-588-5943
Fax Number	:

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

Provider Enumeration Date	:	10/23/2008
Last Update Date	:	09/02/2021

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