Healthcare Provider Details

I. General information

NPI: 1962473348
Provider Name (Legal Business Name): MONIQUE A SLAVEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7495 STATE ROAD SUITE 335
CINCINNATI OH
45255
US

IV. Provider business mailing address

7495 STATE ROAD SUITE 335
CINCINNATI OH
45255
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-5512
  • Fax: 513-232-3341
Mailing address:
  • Phone: 513-232-5512
  • Fax: 513-232-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35074182
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: