Healthcare Provider Details

I. General information

NPI: 1487609566
Provider Name (Legal Business Name): STEPHEN J SLADICKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MACEDONIA CHURCH RD
TAYLORSVILLE NC
28681-8414
US

IV. Provider business mailing address

50 MACEDONIA CHURCH RD
TAYLORSVILLE NC
28681-8414
US

V. Phone/Fax

Practice location:
  • Phone: 828-635-8430
  • Fax: 828-330-2038
Mailing address:
  • Phone: 828-635-8430
  • Fax: 828-294-9160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number9801062
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: