Provider Demographics
NPI:1538137740
Name:SLAYMAN, TERRY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:SCOTT
Last Name:SLAYMAN
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0378
Mailing Address - Country:US
Mailing Address - Phone:888-531-7444
Mailing Address - Fax:888-531-7444
Practice Address - Street 1:590 NEWARK GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1436
Practice Address - Country:US
Practice Address - Phone:888-531-7444
Practice Address - Fax:888-531-7444
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0109180OtherUNITED HEALTHCARE ID NUMB
OH000000198540OtherANTHEM ID NUMBER
OH0656848Medicaid
OH080039083OtherRR MEDICARE ID NUMBER
SL0596002Medicare PIN
OH000000198540OtherANTHEM ID NUMBER
OH0109180OtherUNITED HEALTHCARE ID NUMB