Provider Demographics
NPI:1073679064
Name:SLEPIAN, IAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:K
Last Name:SLEPIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:8028 RITCHIE HWY STE 134
Practice Address - Street 2:KAISER PERMANENTE SEVERNA PARK MEDICAL CENTER
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1030
Practice Address - Country:US
Practice Address - Phone:410-553-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB69766Medicare UPIN
MDK679H245Medicare ID - Type Unspecified