Provider Demographics
NPI:1114962826
Name:SLOMSKI, CAROL ANN (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:SLOMSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 COLLIERS WAY
Mailing Address - Street 2:508
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5053
Mailing Address - Country:US
Mailing Address - Phone:304-797-6433
Mailing Address - Fax:304-797-6432
Practice Address - Street 1:651 COLLIERS WAY
Practice Address - Street 2:508
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5053
Practice Address - Country:US
Practice Address - Phone:304-797-6433
Practice Address - Fax:304-797-6432
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052472208600000X
PAMD444110208600000X
WV02399208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2823376Medicaid
PA1026396270001Medicaid
MIC36179008Medicare ID - Type Unspecified
PA1026396270001Medicaid
MIA72783Medicare UPIN