Provider Demographics
NPI:1508497041
Name:SLAVIK, MEGAN (OD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SLAVIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:RATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5572 BRIDGECREEK AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1483
Mailing Address - Country:US
Mailing Address - Phone:330-704-8547
Mailing Address - Fax:
Practice Address - Street 1:4233 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2856
Practice Address - Country:US
Practice Address - Phone:330-494-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006835152W00000X
OHOPT.006836152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist