Provider Demographics
NPI:1679928865
Name:SLUKA, STEPHEN
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SLUKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 S LINDEN RD STE C
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3442
Mailing Address - Country:US
Mailing Address - Phone:810-733-5300
Mailing Address - Fax:810-733-5396
Practice Address - Street 1:1303 S LINDEN RD STE C
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3442
Practice Address - Country:US
Practice Address - Phone:810-733-5300
Practice Address - Fax:810-733-5396
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501008829237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty