Provider Demographics
NPI:1013903855
Name:SLOVEN, DANIEL GREGG (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:GREGG
Last Name:SLOVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 VAN NESS AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6978
Mailing Address - Country:US
Mailing Address - Phone:844-733-2762
Mailing Address - Fax:
Practice Address - Street 1:1100 VAN NESS AVE FL 7
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6978
Practice Address - Country:US
Practice Address - Phone:844-733-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYC17792080P0206X, 208000000X, 2086S0102X
LA3256792080P0206X
IA329762080P0206X
CAC1575502080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1013903855Medicaid
175150012OtherMEDICARE
MO202725511Medicaid
175150012OtherMEDICARE