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General NPI Number Information
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NPI Number | 1396048492
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Entity Type | Organization
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Legal Business Name | HARRIS D SLAVICK MD PA
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 1317 S MAIN RD STE 2A
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City | VINELAND
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State | NJ
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Zip | 08360-6511
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Country | US
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Telephone | 856-691-2225
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Fax | 856-696-6992
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Provider Business Mailing Address
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Address Line | 1317 S MAIN RD STE 2A
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City | VINELAND
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State | NJ
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Zip | 08360-6511
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Country | US
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Telephone | 856-691-2225
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Fax | 856-696-6992
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARRIS D SLAVICK
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Credential | MD
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Telephone | 856-691-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MA28690
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License Number State | NJ
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