Provider Demographics
NPI:1609825405
Name:SLOVEK, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:SLOVEK
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 1:2121 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2012
Mailing Address - Country:US
Mailing Address - Phone:209-668-5210
Mailing Address - Fax:209-668-5217
Practice Address - Street 1:2121 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2012
Practice Address - Country:US
Practice Address - Phone:209-668-5210
Practice Address - Fax:209-668-5217
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75660207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2818635Medicaid
CAB67845Medicare UPIN
CAZZZ26968ZMedicare ID - Type UnspecifiedGROUP #