Provider Demographics
NPI:1881651594
Name:SLAGA, DELIA MARASIGAN (MD)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:MARASIGAN
Last Name:SLAGA
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 1:2400 WALES AVE NW
Mailing Address - Street 2:STE C
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-0804
Mailing Address - Country:US
Mailing Address - Phone:330-837-4467
Mailing Address - Fax:330-837-4688
Practice Address - Street 1:2400 WALES AVE NW
Practice Address - Street 2:SUITE C
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-0804
Practice Address - Country:US
Practice Address - Phone:330-837-4467
Practice Address - Fax:330-837-4688
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35100320173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0281298Medicaid
OH0281298Medicaid