Provider Demographics
NPI:1114996311
Name:SLOMIANY, WALTER P (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:P
Last Name:SLOMIANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:W
Other - Middle Name:PAUL
Other - Last Name:SLOMIANY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:95 LEONARD AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-223-3100
Mailing Address - Fax:724-223-3353
Practice Address - Street 1:67 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1311
Practice Address - Country:US
Practice Address - Phone:724-745-4100
Practice Address - Fax:724-746-9880
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039701E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011901700005Medicaid
P000419OtherGATEWAY
101687OtherUPMC
63921OtherUNISON
000503391OtherHIGHMARK
PA0011901700005Medicaid
503391JXYMedicare PIN
E64139Medicare UPIN