Healthcare Provider Details

I. General information

NPI: 1003862624
Provider Name (Legal Business Name): SCOTT ALAN SLAGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWN AVE GRANDVIEW HOSPITAL
SELLERSVILLE PA
18960
US

IV. Provider business mailing address

PO BOX 13700-1432 GRAND VIEW EMERGENCY MEDICINE ASSOCIATES
PHILADELPHIA PA
19191-1432
US

V. Phone/Fax

Practice location:
  • Phone: 215-453-4000
  • Fax: 610-617-6280
Mailing address:
  • Phone: 800-666-2455
  • Fax: 610-617-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD029352E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: