Provider Demographics
NPI:1922448703
Name:SLEMENDA, COLIN FITZGERALD (DO)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:FITZGERALD
Last Name:SLEMENDA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD STE 570
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3729
Mailing Address - Country:US
Mailing Address - Phone:124-697-6604
Mailing Address - Fax:412-469-7547
Practice Address - Street 1:575 COAL VALLEY RD STE 570
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3729
Practice Address - Country:US
Practice Address - Phone:124-697-6604
Practice Address - Fax:412-469-7547
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT015113390200000X
PAOS020182207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program