MEDICARE: WILLIAM SLAGER

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	363A00000X	Physician Assistant	5601008991	MI

General Provider Information

NPI Number	:	1902360605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SLAGER

Provider Business Mailing Address
First Line	:	3370 STEPHANIE DR
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-7547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 44TH ST SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49508-5008
Country	:	US
Telephone Number	:	616-685-1808
Fax Number	:	616-685-8099

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

Provider Enumeration Date	:	01/27/2019
Last Update Date	:	01/27/2019

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Directions to “ WILLIAM SLAGER ” Practice Location

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