Provider Demographics
NPI:1922195429
Name:SLOAT, GLENN B (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:B
Last Name:SLOAT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:GLENN B SLOAT MD
Mailing Address - Street 2:P.O. BOX 12312
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212
Mailing Address - Country:US
Mailing Address - Phone:518-598-9779
Mailing Address - Fax:518-640-1690
Practice Address - Street 1:THE WOUND CARE CENTER
Practice Address - Street 2:600 NORTHERN BLVD
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1004
Practice Address - Country:US
Practice Address - Phone:518-471-3705
Practice Address - Fax:518-471-3648
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-09-05
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Provider Licenses
StateLicense IDTaxonomies
NY172960207R00000X
NY172962207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02171618Medicaid
NY02171618Medicaid