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NPI Code Detail

MEDICARE: ANDREW T SLEDD MD

MEDICARE: ANDREW T SLEDD MD
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
1208000000XPediatrics PhysicianC141414CA
2208000000XPediatrics PhysicianMD60765787WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1888783OTHERMOANTHEM BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194946467
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW T SLEDD MD
Provider Business Mailing Address
First Line : 27309 MADISON AVE
Second Line :
City : TEMECULA
State : CA
Zip : 92590-5685
Country : US
Telephone Number : 833-574-2273
Fax Number :
Provider Business Practice Location Address
First Line : 1007 39TH AVE SE
Second Line :
City : PUYALLUP
State : WA
Zip : 98374-2192
Country : US
Telephone Number : 253-435-3100
Fax Number : 253-435-3298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 06/29/2022

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Directions to “ ANDREW T SLEDD MD” Practice Location

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