Provider Demographics
NPI:1255486056
Name:SLAVICO, ANDREW JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:SLAVICO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 OLD MILTON PKWY
Mailing Address - Street 2:STE C270
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4414
Mailing Address - Country:US
Mailing Address - Phone:770-442-1911
Mailing Address - Fax:770-663-8905
Practice Address - Street 1:4303 JODECO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8297
Practice Address - Country:US
Practice Address - Phone:770-898-7840
Practice Address - Fax:770-898-7960
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2021-12-23
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Provider Licenses
StateLicense IDTaxonomies
GA037691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F28795Medicare UPIN