Provider Demographics
NPI:1285626358
Name:SLABIC, STAN F (MD)
Entity Type:Individual
Prefix:
First Name:STAN
Middle Name:F
Last Name:SLABIC
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 1:232 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16544-0002
Mailing Address - Country:US
Mailing Address - Phone:814-452-7605
Mailing Address - Fax:814-452-5039
Practice Address - Street 1:232 W 25TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16544-0002
Practice Address - Country:US
Practice Address - Phone:814-452-7605
Practice Address - Fax:814-452-5039
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032321E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010056290003Medicaid
PAP00001248OtherRAILROAD MEDICARE
PA1429324OtherHIGHMARK BC/BS
PA0010056290003Medicaid
PA117695Medicare PIN