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NPI Code Detail

MEDICARE: V. STEPHEN SLANA, M.D., S.C.

MEDICARE: V. STEPHEN SLANA, M.D., S.C.
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
1207W00000XOphthalmology Physician32916WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730155573OTHERWINPI
21891761524OTHERWINPI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750504346
Entity Type Code : Organization
Provider Name (Legal Business Name) : V. STEPHEN SLANA, M.D., S.C.
Provider Business Mailing Address
First Line : 6125 GREEN BAY RD STE 800
Second Line :
City : KENOSHA
State : WI
Zip : 53142-2982
Country : US
Telephone Number : 262-654-0726
Fax Number : 262-654-4365
Provider Business Practice Location Address
First Line : 6125 GREEN BAY RD STE 800
Second Line :
City : KENOSHA
State : WI
Zip : 53142-2982
Country : US
Telephone Number : 262-654-0726
Fax Number : 262-654-4365
Authorized Official
Title or Position : PHYSICIAN
Name : VICTOR STEPHEN SLANA
Credential :
Telephone Number : 262-654-0726
Provider Enumeration Date : 04/11/2007
Last Update Date : 06/24/2008

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