Slattery, Charles A
Slattery, Charles A is an individual health care provider with primary practice located at 7455 S Us Highway 1 , Titusville FL 32780-8115. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Slattery, Charles A can be contacted via phone (321) 264-2100.Contact Information
Primary practice address
7455 S Us Highway 1
Titusville FL 32780-8115
Phone: (321) 264-2100
Fax: (321) 264-2485
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME0051997 | Florida |
Profile Details
| NPI number | 1821291048 |
|---|---|
| LBN Legal business name | Slattery, Charles A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Mar 12th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821291048 | NPPES |
| Florida | Other | 04843 | BLUE SHIELD |
| Florida | MEDICAID | 062108100 | BLUE SHIELD |
| Florida | Other | ME0051997 | BLUE SHIELD |
| Florida | Other | 110165605 | BLUE SHIELD |
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