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General NPI Number Information
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NPI Number | 1548876428
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Entity Type | Individual
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Provider Name | CONNOR SLAVICH AU.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 100 HOSPITAL LN STE 220
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City | DANVILLE
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State | IN
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Zip | 46122-1845
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Country | US
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Telephone | 317-718-6236
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Fax | 317-745-3749
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Provider Business Mailing Address
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Address Line | 5138 BROADWAY ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-1162
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Country | US
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Telephone | 260-229-1460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002736A
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License Number State | IN
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