Provider Demographics
NPI:1629281100
Name:DENIS J SLABY MD INC
Entity Type:Organization
Organization Name:DENIS J SLABY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SLABY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-722-0333
Mailing Address - Street 1:970 E WASHINGTON ST
Mailing Address - Street 2:STE 403
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3332
Mailing Address - Country:US
Mailing Address - Phone:330-722-0333
Mailing Address - Fax:330-723-5431
Practice Address - Street 1:970 E WASHINGTON ST
Practice Address - Street 2:STE 403
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3332
Practice Address - Country:US
Practice Address - Phone:330-722-0333
Practice Address - Fax:330-723-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042792S208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0488771Medicaid
OHDE0509992Medicare ID - Type Unspecified
A80285Medicare UPIN
OHSL0509991Medicare ID - Type Unspecified