Provider Demographics
NPI:1235233727
Name:SLATON, JOEL W (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:W
Last Name:SLATON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-8430
Mailing Address - Fax:
Practice Address - Street 1:CENTER FOR MINIMALLY INVASIVE SURGERY
Practice Address - Street 2:500 HARVARD STREET SE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-8430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43245208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1025402OtherPREFERRED ONE
MN19-00272OtherMEDICA PRIMARY
MN140062OtherUCARE
MN520688000Medicaid
MN267450OtherFAIRVIEW
MN93R61SLOtherBLUE CROSS BLUE SHIELD
MN1101000OtherARAZ
MN19-00271OtherMEDICA CHOICE
MNHP31259OtherHEALTH PARTNERS
MN520688000Medicaid