MEDICARE: DR. TIMOTHY M. SLAVEN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	02002060A	IN
2	207RC0000X	Cardiovascular Disease Physician	25MB08865300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043215288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY M. SLAVEN D.O.

Provider Business Mailing Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	BLDG 200, STE 211
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-677-7776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE.
Second Line	:	BLDG 200, SUITE 211
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234
Country	:	US
Telephone Number	:	609-677-7776
Fax Number	:	609-677-7509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/17/2021

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Directions to “ DR. TIMOTHY M. SLAVEN D.O.” Practice Location

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