Healthcare Provider Details

I. General information

NPI: 1952399768
Provider Name (Legal Business Name): REUBEN SLOAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5671 PEACHTREE DUNWOODY RD NE SUITE 900
ATLANTA GA
30342-5000
US

IV. Provider business mailing address

5671 PEACHTREE DUNWOODY RD NE SUITE 900
ATLANTA GA
30342-5000
US

V. Phone/Fax

Practice location:
  • Phone: 404-847-9999
  • Fax: 404-531-8466
Mailing address:
  • Phone: 404-847-9999
  • Fax: 404-531-8466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number041958
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: