Provider Demographics
NPI:1790005981
Name:SLACK, DONALD F III (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:F
Last Name:SLACK
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:6565 NORTH CHARLES ST
Mailing Address - Street 2:PPE STE 411
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:443-849-3901
Mailing Address - Fax:443-849-3902
Practice Address - Street 1:6565 NORTH CHARLES ST.
Practice Address - Street 2:PPE STE 441
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:443-849-3901
Practice Address - Fax:443-849-3902
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2018-06-20
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Provider Licenses
StateLicense IDTaxonomies
MDD0080447207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine