MEDICARE: DR. DALE EVERETT SLAGEL M.D.

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	207P00000X	Emergency Medicine Physician	0101026588	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930088825	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	172002	OTHER	VA	ANTHEM BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629085865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE EVERETT SLAGEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 247
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23113
Country	:	US
Telephone Number	:	804-747-5770
Fax Number	:	804-747-5746

Provider Business Practice Location Address
First Line	:	7700 E PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4301
Country	:	US
Telephone Number	:	804-747-5770
Fax Number	:	804-747-5746

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	09/18/2012

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Directions to “ DR. DALE EVERETT SLAGEL M.D.” Practice Location

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