Healthcare Provider Details

I. General information

NPI: 1245231265
Provider Name (Legal Business Name): CHARLES E SLOANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PARKVIEW DR STE 2
KITTANNING PA
16201-7138
US

IV. Provider business mailing address

PO BOX 850
WORTHINGTON PA
16262-0850
US

V. Phone/Fax

Practice location:
  • Phone: 724-645-3663
  • Fax: 724-545-6905
Mailing address:
  • Phone: 724-543-3663
  • Fax: 724-545-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number023414E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: