Provider Demographics
NPI:1548219488
Name:SLOMPAK-PATTON, CAROL A (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:SLOMPAK-PATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:798 HAUSMAN RD STE 270
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9103
Practice Address - Country:US
Practice Address - Phone:610-432-6862
Practice Address - Fax:610-432-9705
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029922E207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA198705OtherHIGHMARK PA BLUE SHIELD
PA01037401OtherCAPITAL BLUE CROSS
PA380001488OtherPALMETTO GBA MEDICARE
PA198705H9MMedicare PIN
PA380001488OtherPALMETTO GBA MEDICARE
PA198705KZJMedicare PIN